scholarly journals Spontaneous Thrombosis of a High-Flow Carotid-Cavernous Fistula after Failed Transarterial Balloon Occlusion

2004 ◽  
Vol 10 (3) ◽  
pp. 253-256 ◽  
Author(s):  
A. Uchino ◽  
Y. Takase ◽  
T. Koizumi ◽  
S. Kudo
Keyword(s):  
Balloon Occlusion ◽  
High Flow ◽  
Carotid Cavernous Fistula ◽  
Spontaneous Thrombosis ◽  
Complete Occlusion ◽  
Cavernous Fistula ◽  
Occlusion Technique ◽  
One Year ◽  
Balloon Occlusion Technique

A 62-year-old man with a traumatic high-flow right carotid-cavernous fistula was treated by transarterial balloon occlusion technique. However, because of the relatively small size of the fistula, the balloon could not enter into the cavernous sinus via the fistula. During the procedure, the shunt flow decreased significantly, and we stopped the procedure. Follow-up angiography performed 14 days after the procedure showed complete occlusion of the fistula with a small residual pseudoaneurysm. One year later, the pseudoaneurysm had decreased in size. Repeated transient decrease and stagnancy of blood flow at the fistula during the balloon procedure may have played an important role in the thrombosis in this patient.

scholarly journals Traumatic Carotid Cavernous Fistula Concomitant with Pseudoaneurysm in the Sphenoid Sinus

2008 ◽  
Vol 14 (1) ◽  
pp. 59-68 ◽  
Author(s):  
R.C. Huai ◽  
C.L. Yi ◽  
L.B. Ru ◽  
G.H. Chen ◽  
H.H. Guo ◽  
...  
Keyword(s):  
High Speed ◽  
Sphenoid Sinus ◽  
Lateral Wall ◽  
Clinical History ◽  
Balloon Occlusion ◽  
Parent Artery ◽  
Carotid Cavernous Fistula ◽  
Efficient Treatment ◽  
Cavernous Fistula

This study was designed to elucidate the generating mechanism, diagnosis and treatment of traumatic carotid cavernous fistula (tCCF) concomitant with pseudoaneurysm in the sphenoid sinus. Six cases of tCCF concomitant with pseudoaneurysm in the sphenoid sinus were analyzed in this study. Clinical history, neurological examination, CT and MRI scans, pre- and postembolization cerebral angiograms and follow-up data were included. All patients presented with massive epistaxis and symptoms of tCCF. The pseudoaneurysms and fistulas were occluded with detachable balloons, and preservation of the parent artery in two cases. One patient also had indirect carotid cavernous fistula (CCF) on the contralateral side embolized by transfacial vein approach with microcoils. Complete symptom resolution was achieved in all cases, without procedure related complications. During the follow-up period all patients returned to work. Falling from a high speed motorcycle without wearing a helmet may be one of the main causes of this disease. The site of impact during the accident mostly localizes in the frontal and lateral of the orbit. Intracavernous sinus hypertension of tCCF combining with fracture of the lateral wall of the sphenoid may lead to the formation of a pseudoaneurysm in the sphenoid sinus. MRI scan is very helpful in the diagnosis of this disease before the patient receives angiography. Detachable balloon occlusion of the pseudoaneurysm and fistula is a safe and efficient treatment.

Temporary Balloon Occlusion of the Cavernous Carotid Artery for Removal of an Orbital and Intracranial Foreign Body: Case Report

Neurosurgery ◽  
2004 ◽  
Vol 55 (5) ◽  
pp. E1240-E1243 ◽  
Author(s):  
Edwin J. Cunningham ◽  
Barbara Albani ◽  
Thomas J. Masaryk ◽  
Peter A. Rasmussen
Keyword(s):  
Foreign Body ◽  
Carotid Artery ◽  
Cavernous Sinus ◽  
Balloon Occlusion ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Angiography Suite ◽  
Cavernous Carotid Artery ◽  
Temporary Balloon Occlusion

Abstract OBJECTIVE AND IMPORTANCE: We describe the first reported use of temporary balloon occlusion of the cavernous internal carotid artery for controlled removal of a foreign object from the cavernous sinus. This endovascular approach may be an alternative to craniotomy in highly selected cases. CLINICAL PRESENTATION: A 34-year-old incarcerated male attempted suicide by stabbing the earpiece of his glasses through his right orbit into the intracranial compartment. He presented with complete ophthalmoplegia. The earpiece traversed the cavernous sinus, penetrating its posterior wall to enter the perimesencephalic cistern and cerebellum. Angiography demonstrated a small direct carotid-cavernous fistula. INTERVENTION: Removal of the foreign body was performed under general anesthesia in the angiography suite with the operating room on standby. Nondetachable and detachable balloons were inflated in the cavernous carotid artery to provide vascular control while the foreign body was withdrawn from the cranium at the orbit. Follow-up angiographic runs with the balloons deflated revealed minimal arteriovenous shunting, which disappeared on subsequent studies. The balloons were removed. The patient remained neurologically stable with his baseline right ophthalmoplegia and V1–V2 hemianesthesia. At the 6-week follow-up, the patient remained clinically stable with no evidence of carotid-cavernous fistula or interval abscess formation. CONCLUSION: Endovascular temporary balloon occlusion of the cavernous carotid artery provides immediate control of the vessel (with an option of permanent carotid sacrifice), allowing removal of a foreign body without craniotomy in appropriate cases.

scholarly journals Spontaneous Petrous Carotid Artery Occlusive Dissection Treated by Local Fibrinolysis and Stent Deployment

2004 ◽  
Vol 10 (2) ◽  
pp. 145-149
Author(s):  
G. Villa ◽  
M. Cellerini ◽  
S. Mangiafico ◽  
F. Ammannati ◽  
G. P. Giordano
Keyword(s):  
Transient Ischemic Attacks ◽  
Carotid Cavernous Fistula ◽  
Stent Deployment ◽  
Cavernous Fistula ◽  
Efficacious Treatment ◽  
Local Fibrinolysis ◽  
Local Thrombolytic Therapy ◽  
One Year ◽  
Spontaneous Dissection

This paper reports a case of local thrombolytic therapy followed by stenting of the petrous carotid in a young woman with recurrent transient ischemic attacks from spontaneous dissection. A total of four overlapping balloon-expandable stents were delivered in two different sessions one month apart. The procedure resulted in a potentially efficacious treatment for the prevention or reduction of cerebral damages from ischemia. At follow-up three months later the patient was symptom free and DSA revealed a delayed proximal small pseudoaneurysm and a carotid-cavernous fistula. At one year follow-up the patient was still symptom-free with unmodified findings at cerebral angiography.

scholarly journals Bilateral Persistent Pharyngo-Stapedial Arteries Revealed during Evaluation of a Carotid-Cavernous Fistula

2006 ◽  
Vol 12 (4) ◽  
pp. 327-334 ◽  
Author(s):  
J. Jehl ◽  
L. Jeunet ◽  
M. Berraiah ◽  
J.-F. Bonneville
Keyword(s):  
Carotid Cavernous Fistula ◽  
Spontaneous Thrombosis ◽  
Cavernous Fistula ◽  
Stapedial Artery ◽  
Temporal Bone Ct ◽  
Detachable Coils ◽  
Vascular Steal ◽  
The Right ◽  
High Degree

A 33-year-old woman was evaluated for a right carotid-cavernous fistula revealed by a proptosis and chemosis of the right eye. The initial angiogram showed a left persistent pharyngo-stapedial artery (Ph-SA). A temporal bone CT suggested bilateral pharyngo-stapedial artery persistence. The right Ph-SA was not opacified in the first angiogram because of the high degree of shunting in the fistula. Four months later the patient was admitted for treatment of the carotid-cavernous fistula. In the meantime, the fistula had altered, with spontaneous thrombosis of the ophthalmic vein, and decrease of the vascular steal, explaining that the right Ph-SA was clearly visible on the angiogram performed during the procedure. The carotid-cavernous fistula was completely occluded with five detachable coils. The follow-up included 3 Tesla MR angiography that showed complete closure of the fistula with preservation of the right ICA and bilateral persistent pharyngo-stapedial arteries.

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.

Balloon Occlusion of a Recurrent Carotid-Cavernous Fistula Previously Treated by Carotid Ligations

Neurosurgery ◽  
1986 ◽  
Vol 19 (4) ◽  
pp. 643-648 ◽  
Author(s):  
O'Reilly Gerald V. ◽  
John Shillito ◽  
Hani A. Haykal ◽  
Jonathan Kleefield ◽  
Wang Ay-Ming ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Balloon Catheter ◽  
Balloon Occlusion ◽  
Intracranial Bleeding ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Previously Treated

Abstract A carotid-cavernous fistula recurred 16 years after a Hamby procedure. The recurrence was manifested by subarachnoid hemorrhage originating from dilated draining pial veins. The fistula was closed with a balloon catheter introduced through a patent remnant of the cervical carotid artery. Patients who have previously undergone Hamby trapping and embolization should be reassessed for an occult fistula that could predispose them to intracranial bleeding.

scholarly journals Successful treatment of acquired uterine arterial venous malformation using N-butyl-2-cyanoacrylate under balloon occlusion

2014 ◽  
Vol 3 (8) ◽  
pp. 204798161454591
Author(s):  
Reiko Woodhams ◽  
Go Ogasawara ◽  
Kenichiro Ishida ◽  
Kaoru Fujii ◽  
Takuro Yamane ◽  
...  
Keyword(s):  
Uterine Artery ◽  
Venous Malformation ◽  
Arterial Embolization ◽  
Balloon Occlusion ◽  
High Flow ◽  
Embolic Agent ◽  
Complete Occlusion ◽  
Occlusion Balloon ◽  
Multiple Feeding ◽  
Diffuse Distribution

We present two cases of acquired uterine arterial venous malformation (AVM) which was diagnosed because of massive genital bleeding successfully treated with transcatheter arterial embolization (TAE), using N-butyl-2-cyanoacrylate (NBCA) under balloon occlusion. Balloon occlusion at the uterine artery was performed in both patients for diffuse distribution of NBCA in multiple feeding branches, as well as to the pseudoaneurysm, and for the prevention of NBCA reflux. In one of our patients, balloon occlusion of the draining vein was simultaneously performed to prevent NBCA migration through accompanying high-flow arteriovenous fistula (AVF). Doppler ultrasound at 6 months of both patients documented persistent complete occlusion of AVM. Complete and safe obliteration of acquired uterine AVM was accomplished using NBCA as embolic agent, under balloon occlusion at the communicating vessels of acquired uterine AVM.

scholarly journals Endovascular treatment of carotid-cavernous fistula type A with platinium coils

2008 ◽  
Vol 65 (12) ◽  
pp. 923-926 ◽  
Author(s):  
Slobodan Culafic ◽  
Robert Juszkat ◽  
Sinisa Rusovic ◽  
Dara Stefanovic ◽  
Ljubodrag Minic ◽  
...  
Keyword(s):  
Type A ◽  
Endovascular Embolization ◽  
High Flow ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Vertebrobasilar Artery ◽  
Eye Symptoms ◽  
The Right ◽  
Carotid Cavernous Fistulas ◽  
Platinum Coils

Background. Carotid-cavernous fistulas are abnormal communications between carotid arteries or their branches and the cavernous system caused mostly by trauma. Posttraumatic fistulas represent 70% of all carotid-cavernous fistulas and they are mostly high-flow shunts (type A). This type gives characteristic eye symptoms. Case report. This paper presents a 44-year old male patient with carotidcavernous fistula as a result of penetrating head injury. In clinical presentation the patient had exophthalmos, conjunctival chemosis and weakening of vision on the right eye, headache and diplopia. Digital subtracted angiography showed high-flow carotid-cavernous fistula, which was vascularised from the left carotid artery and from vertebrobasilar artery. Endovascular embolization with platinum coils was performed through the transarterial route (endoarterial approach). Check angiogram confirmed that the fistula was closed and that no new communications developed. Conclusion. Embolization of complex carotidcavernous fistula type A was successfully performed with platinum coils by endovascular approach.

Sign in / Sign up

Export Citation Format

Share Document