scholarly journals Transvenous embolization of dural carotid cavernous fistula through the facial and ophthalmic vein

2011 ◽  
Vol 68 (12) ◽  
pp. 1079-1083 ◽  
Author(s):  
Branko Prstojevic ◽  
Mirko Micovic ◽  
Ivan Vukasinovic ◽  
Mirjana Nagulic
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Superior Ophthalmic Vein ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
The Right ◽  
Transvenous Approach

Introduction. Dural carotid cavernous fistula is acquired, relatively rare, condition comprising of numerous smallcaliber meningeal arterial branches, draining directly into cavernous sinus. Endovascular therapy is the treatment of choice, preferably by a transvenous approach. In the case of inaccessible inferior petrosal sinus, other alternative routes are considered. We presented a case of dural carotid cavernous fistula completely occluded with Guglielmi detachable coils, using a transvenous approach through facial and superior ophthalmic vein. Case report. A 62-year-old man was referred with a gradual worsening proptosis, red eye, and decreased visual acuity, on the right side. Digital subtraction angiography revealed the presence of a right dural carotid cavernous fistula, predominantly supplied from dural branches of the right internal carotid artery siphon, with minimal contribution from the right middle meningeal artery and contralateral dural branches of the left internal carotid artery siphon. The fistula was drainaged through the dilated superior ophthalmic vein, and via the facial to the internal jugular vein. There was neither pacification of pterygoid and petrous sinuses, nor cortical venous reflux. Endovascular treatment was performed by a transvenous approach. A guiding catheter was placed in the right facial vein. A microcatheter was advanced through the dilated angular and superior ophthalmic vein, and its tip positioned into the right cavernous sinus. Coils were deployed, until a complete angiographic occlusion of the fistula had been achieved. The patient experienced rapid improvement in the symptoms, with complete normalization of his condition one month after the treatment. Conclusion. Coil embolization of dural carotid cavernous fistula by transvenous catheterization, through the facial and superior ophthalmic vein, can be considered as safe and effective treatment option in the presence of marked anterior drainage.

scholarly journals P.117 Delayed contralateral presentation of a carotid cavernous fistula following trauma

2016 ◽  
Vol 43 (S2) ◽  
pp. S47-S47
Author(s):  
S Husak ◽  
R Ko ◽  
M Kelly
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Signs And Symptoms ◽  
Anterior Communicating Artery ◽  
Left Internal Carotid Artery ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Contralateral Approach ◽  
The Right

Background: We present a rare case of a left-sided carotid cavernous fistula (CCF) that presented 15 months post initial trauma with right-sided ophthalmic signs and symptoms. Highlighted is a contralateral endovascular approach to treating this traumatic CCF. Methods: Described is a case of a left-sided CCF caused by a self-inflicted gun shot wound to the head that was initially treated conservatively by neurosurgery and opthomology. The patient presented 15 months later with headache, acute right-sided periorbital swelling, severe right eye and facial pain. Results: Angiography confirmed the presence of a left-sided CCF with preferential drainage into the right cavernous sinus and right superior ophthalmic vein. The left internal carotid artery (ICA) was shown to be narrow and irregular. Multiple attempts to navigate the micro catheter through the vessel were unsuccessful. Instead, the fistula was embolized using a contralateral approach through the right internal carotid artery and across the anterior communicating artery. Imaging post-operatively confirmed successful occlusion of the CCF. Conclusions: This case is a rare example of a left-sided ICA occlusion secondary to trauma presenting 15 months after the initial injury with right-sided ophthalmic signs and symptoms. It is also one of only a few in the literature that describe successful treatment of traumatic CCF through a contralateral approach.

Direct Surgery for Posttraumatic Carotid-cavernous Fistula as a Result of an Intradural Pseudoaneurysm: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 51 (4) ◽  
pp. 1071-1074 ◽  
Author(s):  
Yoshihiko Fu ◽  
Kenji Ohata ◽  
Naohiro Tsuyuguchi ◽  
Mitsuhiro Hara
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Traffic Accident ◽  
Internal Carotid ◽  
Clinical Presentation ◽  
Posterior Communicating Artery ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
The Right ◽  
Embolization Procedure

Abstract OBJECTIVE AND IMPORTANCE Traumatic carotid-cavernous fistula (CCF) is currently treated with interventional neuroradiological embolization procedures. A rare case of posttraumatic CCF that resulted from an intradural pseudoaneurysm is presented. The patient was treated by direct surgery because an embolization procedure was not suitable. CLINICAL PRESENTATION A 16-year-old boy developed chemosis in the right eye 17 days after a traffic accident. Angiography revealed a pseudoaneurysm that arose from the site of origin of the posterior communicating artery, drained directly into the cavernous sinus, and formed a high-flow CCF. INTERVENTION Direct surgery was performed to repair the arterial laceration at the junction of the internal carotid artery and the posterior communicating artery. A clip was applied along the internal carotid artery. The posterior stump of the damaged posterior communicating artery was also included in the clip. Postoperatively, the CCF and pseudoaneurysm were completely obliterated, and the symptoms were cured. CONCLUSION Awareness of an unusual intradural origin of a CCF and the possibility of a direct surgical treatment should be kept in mind.

scholarly journals Endovascular Treatment of a Large Venous Pouch Direct Carotid Cavernous Fistula

2013 ◽  
Vol 26 (1) ◽  
pp. 89-93
Author(s):  
M. Mahmoud ◽  
M.H. Elsissy
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Vertebrobasilar System ◽  
Distal Aspect ◽  
Direct Carotid Cavernous Fistula

Endovascular treatment of direct carotid cavernous fistula (CCF) can be performed by either arterial or venous approaches. The aim is to disconnect the fistula with or without preservation of the internal carotid artery (ICA). The aim of this article is to describe a technique for embolization of the cavernous sinus and the ICA in direct CCF using coils. Trapping the distal aspect of the fistula using a retrograde navigation via the vertebrobasilar system and the posterior communicating artery was performed in two cases. Clinical and radiological evolutions are described.

scholarly journals Carotid Cavernous Fistula possibly due to the Rupture of Petrous Portion Aneurysm of the Right Internal Carotid Artery

2005 ◽  
Vol 14 (10) ◽  
pp. 628-633
Author(s):  
Goji Fushihara ◽  
Junichi Adachi ◽  
Shoichiro Ishihara ◽  
Akira Satoh ◽  
Masao Matsutani
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Petrous Portion ◽  
The Right

scholarly journals Transarterial Embolization of an Indirect Carotid- Cavernous Fistula with N-Butyl Cyanoacrylate

2018 ◽  
Vol 25 (2) ◽  
pp. 150-156
Author(s):  
Matías Negrotto ◽  
Roberto Crosa ◽  
Alejandra Jaume ◽  
Fiorella Casanova
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Transarterial Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas

Carotid-cavernous fistulas are vascular shunts that allow blood to flow from the carotid artery into the cavernous sinus. Some fistulas are characterized by a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus. Other carotid-cavernous fistulas are dural, consisting of a communication between the cavernous sinus and one or more meningeal branches of the internal carotid artery, the external carotid artery, or both. Endovascular management is the treatment modality of choice in these cases. We report the use of N-butyl cyanoacrylate in a successful transarterial embolization of a dural carotid-cavernous fistula fed by arterial branches of the internal -and mainly- external carotid arteries (Barrow type D).

scholarly journals Direct Carotid-Cavernous Fistula with early drainage into inferior petrous sinus

2021 ◽  
Vol 29 ◽  
pp. 1-9
Author(s):  
Olavo Leite de Macêdo Neto ◽  
Amanda Menezes Morgado ◽  
Rafael Dos Santos Araujo ◽  
José Silva Souza ◽  
Ana Carla Da Silva Mendes ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
The Third ◽  
The Right ◽  
Carotid Cavernous Fistulas ◽  
Direct Carotid Cavernous Fistula

Carotid-cavernous fistulas (CCF) are classified in direct (Barrow A) and indirect. The direct comunication between the cavernous segment of the internal carotid artery and the cavernous sinus defines direct CCF. In the present case, is described a 51-year-old female patient, diagnosed with subarachnoid hemorrhage through head tomography. The patient underwent an agiographic study, wen was identified a large dissecant aneurysm in the right internal carotid artery and a direct CCF with early drainage into the ophthalmic vein and inferior petrous sinus, manifesting paralysis of the third cranial nerve.

Venous rupture during transvenous approach to a carotid-cavernous fistula

1989 ◽  
Vol 71 (1) ◽  
pp. 133-137 ◽  
Author(s):  
Wesley A. King ◽  
Grant B. Hieshima ◽  
Neil A. Martin
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
Balloon Occlusion ◽  
Alternative Methods ◽  
Ocular Motility ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
A Minor ◽  
Transvenous Approach

✓ An attempt at transfemoral transarterial balloon occlusion of a high-flow spontaneous carotid-cavernous fistula was unsuccessful because the carotid artery rent was too small for this approach. During a subsequent transvenous approach to the cavernous sinus through the jugular vein, the inferior petrosal sinus was perforated. A minor subarachnoid hemorrhage occurred before the tear could be sealed by the deposition of three Gianturco coils in the vein. The patient was taken to the operating room for emergency obliteration of the fistula and petrosal sinus in order to remove the risk of further hemorrhage. Under the guidance of intraoperative digital subtraction angiography, isobutyl-2-cyanoacrylate was injected directly into the surgically exposed cavernous sinus. Successful obliteration of the fistula was achieved with preservation of the carotid artery, and the angiography catheter was removed safely from the petrosal sinus. Although initially after surgery the patient had nearly complete ophthalmoplegia, at her 1-year follow-up examination she had normal ocular motility and visual acuity. The transvenous approach to the cavernous sinus and alternative methods of treatment of carotid-cavernous fistulas are discussed.

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