scholarly journals Transvenous Embolization of Primitive Trigeminal Artery Variant-Cavernous Fistula with Guglielmi Detachable Coils

2008 ◽  
Vol 14 (2_suppl) ◽  
pp. 95-98 ◽  
Author(s):  
Yi-Ming Wu ◽  
Ho-Fai Wong
Keyword(s):  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Inferior Petrosal Sinus ◽  
Digital Subtraction ◽  
Trigeminal Artery ◽  
Guglielmi Detachable Coils ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Detachable Coils ◽  
Primitive Trigeminal Artery

Here, we present a 32-year-old male with proptosis and chemosis of the left eye following a close head injury. Digital subtraction angiography of the left internal carotid artery showed a left carotid-cavernous fistula (CCF) associated with a primitive trigeminal artery (PTA) variant. The patient was successfully treated with transvenous Guglielmi detachable coils embolization via the inferior petrosal sinus. The PTA variant was preserved without cerebellar or brainstem infarct.

scholarly journals Guidewire-Induced Carotid Cavernous Fistula

2001 ◽  
Vol 7 (2) ◽  
pp. 161-165 ◽  
Author(s):  
T.-S. Kim ◽  
M. Ezura ◽  
A. Takahashi ◽  
S. Nishimura ◽  
T. Yoshimoto
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Endovascular Embolization ◽  
Guglielmi Detachable Coils ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Small Branch ◽  
Detachable Coils

A rare case of carotid cavernous fistula occurring during endovascular embolization of the left carotid cave aneurysm in a 48-year-old female is reported. It was thought to be caused by the tear of a small branch derived from the intracavernous internal carotid artery while the guidewire was passing the sharp posterior bend of the intracavernous internal carotid artery. The left carotid cave aneurysm was completely occluded with five Guglielmi detachable coils assisted by neck plasty technique. It was decided to follow-up the carotid cavernous fistula since it was asymptomatic. Follow-up angiogram performed two weeks later revealed spontaneous obliteration of the carotid cavernous fistula.

Trigeminal Neuralgia Associated with a Primitive Trigeminal Artery Variant: Case Report

Neurosurgery ◽  
2003 ◽  
Vol 52 (5) ◽  
pp. 1217-1220
Author(s):  
Yoji Tamura ◽  
Hiroshi Shimano ◽  
Toshihiko Kuroiwa ◽  
Yoshihito Miki
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Trigeminal Neuralgia ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Decompression Surgery ◽  
Trigeminal Artery ◽  
Cerebellar Artery ◽  
Primitive Trigeminal Artery ◽  
Perforating Arteries

Abstract OBJECTIVE AND IMPORTANCE A variant type of the primitive trigeminal artery (PTA) is a rare anomalous vessel that originates from the internal carotid artery and directly supplies the territory of the anteroinferior cerebellar artery and/or the superior cerebellar artery. We report a case of trigeminal neuralgia associated with this PTA variant, and we discuss the characteristics of this vessel. CLINICAL PRESENTATION A 51-year-old woman presented with a 10-year history of left paroxysmal facial pain. Magnetic resonance angiography and cerebral angiography demonstrated that an aberrant vessel originating from the left internal carotid artery directly supplied the cerebellum, without a basilar artery anastomosis. INTERVENTION Surgical exploration was performed via a left retrosigmoid approach. A loop of the aberrant vessel, which entered the posterior fossa through the isolated dural foramen, was compressing the trigeminal nerve. This aberrant vessel was displaced medially from the nerve with a prosthesis, with care to avoid kinking and avulsion of the perforating arteries. The patient's neuralgia resolved postoperatively. CONCLUSION Although the PTA variant is frequently associated with intracranial aneurysms, it is extremely rare for the variant to lead to trigeminal neuralgia. During microvascular decompression surgery, surgeons should be careful to prevent injury of the perforating arteries arising from the PTA variant.

scholarly journals Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

2012 ◽  
Vol 01 (01) ◽  
pp. 072-074
Author(s):  
Anthony Sin ◽  
Hugo Cuellar ◽  
Benjamin Brown
Keyword(s):  
Endovascular Treatment ◽  
Cavernous Sinus ◽  
Coil Embolization ◽  
Internal Carotid ◽  
Trigeminal Artery ◽  
Carotid Cavernous Fistula ◽  
Unique Challenge ◽  
Cavernous Fistula ◽  
Catheter Technique ◽  
Safe Treatment Option

Abstract We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA) laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.

scholarly journals Endovascular GDC Treatment of an Idiopathic Carotid-Cavernous Fistula Caused by Aneurysmal Rupture of the Intra-Cavernous Carotid Artery

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 174-177 ◽  
Author(s):  
Y. Tatewaki ◽  
S. Nishimura ◽  
M. Ezura ◽  
A. Nishino ◽  
K. Sasaki ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Left Internal Carotid Artery ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Aneurysmal Rupture ◽  
Long Term Follow Up ◽  
Superior Petrosal Sinus ◽  
Detachable Coils ◽  
Endovascular Approach ◽  
Cavernous Carotid Artery

Aneurysmal rupture of the intra-cavernous carotid artery may cause idiopathic carotid-cavernous fistula (CCF), and the treatment choice for occluding shunting fistula in this type of CCF is an endovascular approach using detachable balloons. However, little has been reported on treating such lesions with the intra-aneurysmal embolization using Guglielmi detachable coils (GDCs). To our knowledge, ours is the first reported case of successful treatment by selective intra-fistula and intra-aneurysmal embolization with GDCs. A 74-year-old woman exhibited proptosis and chemosis of her left eye over a period of one month. Symptoms of double vision in conversion and pulsatile murmur in her left eye were also noted. Angiography revealed an intra-cavernous aneurysm of the left internal carotid artery (ICA) with a shunting fistula, which drained into the dilated cavernous sinus, superior orbital vein (SOV), superior petrosal sinus, inferior petrosal sinus, and pterygoid plexus. We thought the fistula would occlude by intra-aneurysmal embolization, but we had no confidence of tight packing of the aneurysm since the aneurismal neck was relatively wide. So, we embolized the venous side of the shunting fistula and then the dome of the aneurysm with GDCs. Immediately after the operation, her symptoms and signs were ameliorated, and complete occlusion of the CCF was observed on long-term follow-up. We suggest selective intra-fistula and intra-aneurysmal embolization with GDCs as an alternative method of treatment of idiopathic CCF originating from aneurysmal rupture of the intra-cavernous carotid artery.

Treatment of spontaneous carotid—cavernous fistula in Ehlers—Danlos syndrome by transvenous occlusion with Guglielmi detachable coils

2000 ◽  
Vol 93 (4) ◽  
pp. 689-692 ◽  
Author(s):  
Andrew A. Kanner ◽  
Shimon Maimon ◽  
Zvi H. Rappaport
Keyword(s):  
Treatment Options ◽  
Guglielmi Detachable Coils ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Content Type ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Detachable Coils ◽  
First Time ◽  
Danlos Syndrome

✓ The authors report on a young woman with Ehlers—Danlos syndrome (EDS) Type IV in whom a spontaneous direct carotid—cavernous fistula (CCF) was treated by transvenous occlusion with regular and fiber-coated Guglielmi detachable coils. To the authors' knowledge, this is the first time this approach has been used in a patient with EDS. The different treatment options are discussed, and the literature on endovascular treatment of direct CCFs in EDS is reviewed.

Aneurysm on a Persisting Primitive Trigeminal Artery Occluded with Guglielmi Detachable Coils

1998 ◽  
Vol 4 (1) ◽  
pp. 91-93 ◽  
Author(s):  
J. Nepper-Rasmussen ◽  
P. Bjerre ◽  
P. Andersen
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Ruptured Aneurysm ◽  
Parent Artery ◽  
Trigeminal Artery ◽  
Guglielmi Detachable Coils ◽  
Sixth Cranial Nerve ◽  
Detachable Coils ◽  
Primitive Trigeminal Artery

A persisting primitive trigeminal artery (PPTA) is present in 0.2 – 0.6% of all cerebral angiographies. 27 cases of PPTA aneurysms have been reported. We present a case with sixth cranial nerve palsy due to a non ruptured aneurysm on a persisting primitive trigeminal artery. The aneurysm was successfully occluded with Guglielmi Detachable Coils with preservation of the parent artery. The cranial nerve palsy resolved and recovery was uneventful.

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