scholarly journals A Poorly Treated Carotid-Cavernous Fistula Rescued by Coils through a PComA Approach

2009 ◽  
Vol 15 (2) ◽  
pp. 197-201
Author(s):  
J. Yu ◽  
Z. Shi ◽  
M. Lv ◽  
X. Yang ◽  
Z. Wu

This study describes a case of traumatic carotid-cavernous fistula poorly treated with balloons and rescued by coils through a PComA approach. A six-year-old boy suffered a left temporal bone puncture wound. Digital subtraction angiography disclosed a left carotid cavernous fistula. Five balloons were implanted into the cavernous sinus and the parent artery was sacrificed unwillingly, but the residual fistula retro-engorged by the ophthalmic artery communicated with the maxillary artery and the post circle through the PComA. We finally occluded the residual fistula through the PComA with coils. Once the parent artery was sacrificed and the distal residual fistula still retro-engorged, another patent communicating artery may be a rescue approach.

2021 ◽  
Vol 06 (03) ◽  
pp. 40-45
Author(s):  
Dr. Sirisha Gantela ◽  
◽  
Dr. N. Lakshmi Chowdary ◽  
Dr. M. Satyanarayana ◽  
◽  
...  

Aim: The purpose of the study is to report the ocular manifestations of Carotid cavernous fistula. Toconfirm the diagnosis by radiological investigations and to evaluate the clinical outcome aftermanagement. Materials and Methods: Patients who presented to the ophthalmology departmentwith signs and symptoms of carotid-cavernous fistula were evaluated by clinical examinationfollowed by radiological investigations like ultrasound, Doppler, CT scan and MRI. They laterunderwent DSA ( Digital Subtraction Angiography) for confirmation followed by definitive treatment.Results: Out of four patients who had direct CCF, three cases were managed by endovascularembolization of the parent artery. The remaining one case was conservatively managed by carotidmassage as it was a low flow fistula and the patient also had Parkinson’s disease. Four cases thathad indirect CCF were managed by carotid massage. Complete closure of the fistula is seen in allcases. Patients were followed up for 1 month, 3 months and 6 months and clinical outcome wasevaluated. Conclusion: CCF should be suspected in the presence of arteriolised conjunctivalvessels, proptosis and audible bruit. Diagnosis is by radiological tests like ultrasonography, Doppler,CT scan and MRI. The confirmatory test is digital subtraction angiography (DSA). Direct CCF iseffectively treated with endovascular therapy by coiling the fistula and indirect CCF is managed bymanual compression. Early diagnosis and treatment can prevent sight-threatening complications.


1985 ◽  
Vol 8 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Kimberly N. Wiele ◽  
Supranee Tantana ◽  
Thomas Pilla ◽  
Carol R. Archer

2010 ◽  
Vol 50 (5) ◽  
pp. 404-406 ◽  
Author(s):  
Shinya KOHYAMA ◽  
Shoichiro ISHIHARA ◽  
Fumitaka YAMANE ◽  
Ryuzaburo KANAZAWA ◽  
Hideaki ISHIHARA ◽  
...  

2021 ◽  
Vol 14 (11) ◽  
pp. e245922
Author(s):  
Ivo Petrov ◽  
Zoran Stankov ◽  
Damyan Boychev ◽  
Marko Klissurski

Carotid cavernous fistulas are abnormal communications between the carotid artery or its branches and the cavernous sinus. It can be traumatic or spontaneous. The widely accepted treatment is by detachable balloons. Advancements in the field of endovascular medicine made available other options for the treatment of this condition. Covered stents are widely available and offer preservation of the parent artery while occluding the fistula.


2021 ◽  
Vol 5 (3) ◽  
pp. 533-563
Author(s):  
Laila Amalia ◽  
Hartono Yudi Sarastika ◽  
Bambang Soeprijanto

Introduction: CT angiography (CTA) is the initial modality for diagnosing theCarotid Cavernous Fistula (CCF), identifying the type of CCF, measuring thediameter of the fistula and the diameter of the internal carotid artery (ICA) pre andpost fistula, and then confirmed by Digital Subtraction Angiography (DSA) as thegold standard. CTA is expected to provide more information to improve theaccuracy of CCF diagnosis to benefit therapy and prevent complications. Thisstudy aimed to determine the diagnostic value of CTA in CCF patients in Dr.Soetomo General Hospital Surabaya, using the DSA as a gold standard. Methods:An observational retrospective study of CCF patients met the inclusion andexclusion criteria and underwent CTA and DSA examinations at the RadiologyInstallation of Dr. Soetomo General Hospital, Surabaya, from January 2016 toJuly 2020. Results: In the comparison of types of CCF CTA to DSA, the directgroup was 53.8% and 57.7%, respectively, while the indirect group was 46.1% and42.3% with a very strong correlation (κ = 0.922; p = 0.000), sensitivity was 93.3%,specificity was 100 %, PPV of 100%, NPV of 91.7% and accuracy of 96.15%. Directtype evaluation on the DSA showed a large picture of the fistula diameter; the ICApre fistula's size was enlarged; therefore, the ICA post fistula diameter wasreduced or absent. There was a strong correlation of fistula diametermeasurement results between CTA and DSA (r = 0.695, p = 0.006).Conclusion: CTA has a similarity rate of 92.2% with DSA in identifying the typeof CCF. The accuracy value of CTA is close to DSA in fistula diametermeasurements.


2021 ◽  
Vol 5 (6) ◽  
pp. 520-530
Author(s):  
Laila Amalia ◽  
Hartono Yudi Sarastika ◽  
Bambang Soeprijanto

Background: CT angiography (CTA) is the initial modality for diagnosing the Carotid Cavernous Fistula (CCF), identifying the type of CCF, measuring the diameter of the fistula and the diameter of the internal carotid artery (ICA) pre and post fistula, and then confirmed by Digital Subtraction Angiography (DSA) as the gold standard. CTA is expected to provide more information to improve the accuracy of CCF diagnosis to benefit therapy and prevent complications. This study aimed to determine the diagnostic value of CTA in CCF patients in Dr. Soetomo General Hospital Surabaya, using the DSA as a gold standard. Methods: An observational retrospective study of CCF patients met the inclusion and exclusion criteria and underwent CTA and DSA examinations at the Radiology Installation of Dr. Soetomo General Hospital, Surabaya, from January 2016 to July 2020. Results: In the comparison of types of CCF CTA to DSA, the direct group was 53.8% and 57.7%, respectively, while the indirect group was 46.1% and 42.3% with a very strong correlation (κ = 0.922; p = 0.000), sensitivity was 93.3%, specificity was 100 %, PPV of 100%, NPV of 91.7% and accuracy of 96.15%. Direct type evaluation on the DSA showed a large picture of the fistula diameter; the ICA pre fistula's size was enlarged; therefore, the ICA post fistula diameter was reduced or absent. There was a strong correlation of fistula diameter measurement results between CTA and DSA (r = 0.695, p = 0.006). Conclusion: CTA has a similarity rate of 92.2% with DSA in identifying the type of CCF. The accuracy value of CTA is close to DSA in fistula diameter measurements.


2003 ◽  
Vol 43 (7) ◽  
pp. 369-373 ◽  
Author(s):  
Fujimaro ISHIDA ◽  
Tadashi KOJIMA ◽  
Kenji KAWAGUCHI ◽  
Tamotsu HOSHINO ◽  
Kenichi MURAO ◽  
...  

2016 ◽  
Vol 126 (6) ◽  
pp. 1995-2001 ◽  
Author(s):  
Min Lang ◽  
Ghaith Habboub ◽  
Jeffrey P. Mullin ◽  
Peter A. Rasmussen

Carotid-cavernous fistula was one of the first intracranial vascular lesions to be recognized. This paper focuses on the historical progression of our understanding of the condition and its symptomatology—from the initial hypothesis of ophthalmic artery aneurysm as the cause of pulsating exophthalmos to the recognition and acceptance of fistulas between the carotid arterial system and cavernous sinus as the true etiology. The authors also discuss the advancements in treatment from Benjamin Travers' early common carotid ligation and wooden compression methods to today's endovascular approaches.


2007 ◽  
Vol 67 (4) ◽  
pp. 403-408 ◽  
Author(s):  
Ali Shaibani ◽  
Mehdi Rohany ◽  
Richard Parkinson ◽  
John K. Hopkins ◽  
H. Hunt Batjer ◽  
...  

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