scholarly journals Ocular Manifestations Of Carotid Cavernous Fistula and Clinical Outcome After Management

2021 ◽  
Vol 06 (03) ◽  
pp. 40-45
Author(s):  
Dr. Sirisha Gantela ◽  
◽  
Dr. N. Lakshmi Chowdary ◽  
Dr. M. Satyanarayana ◽  
◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Ct Scan ◽  
Digital Subtraction Angiography ◽  
Low Flow ◽  
Confirmatory Test ◽  
Parent Artery ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Ocular Manifestations

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.

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
Keyword(s):  
Digital Subtraction Angiography ◽  
Temporal Bone ◽  
Cavernous Sinus ◽  
Ophthalmic Artery ◽  
Parent Artery ◽  
Maxillary Artery ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Puncture Wound ◽  
Cavernous Fistula

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.

Localization of carotid cavernous fistula using digital subtraction angiography

1985 ◽  
Vol 8 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Kimberly N. Wiele ◽  
Supranee Tantana ◽  
Thomas Pilla ◽  
Carol R. Archer
Keyword(s):  
Digital Subtraction Angiography ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula

scholarly journals Three-Dimensional Digital Subtraction Angiography for Endovascular Treatment of Direct Carotid-Cavernous Fistula

2010 ◽  
Vol 50 (5) ◽  
pp. 404-406 ◽  
Author(s):  
Shinya KOHYAMA ◽  
Shoichiro ISHIHARA ◽  
Fumitaka YAMANE ◽  
Ryuzaburo KANAZAWA ◽  
Hideaki ISHIHARA ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Direct Carotid Cavernous Fistula

scholarly journals Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

2021 ◽  
Vol 5 (3) ◽  
pp. 533-563
Author(s):  
Laila Amalia ◽  
Hartono Yudi Sarastika ◽  
Bambang Soeprijanto
Keyword(s):  
Digital Subtraction Angiography ◽  
General Hospital ◽  
Ct Angiography ◽  
Strong Correlation ◽  
Gold Standard ◽  
Internal Carotid ◽  
Diagnostic Value ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula

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.

scholarly journals Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

2021 ◽  
Vol 5 (6) ◽  
pp. 520-530
Author(s):  
Laila Amalia ◽  
Hartono Yudi Sarastika ◽  
Bambang Soeprijanto
Keyword(s):  
Digital Subtraction Angiography ◽  
General Hospital ◽  
Ct Angiography ◽  
Strong Correlation ◽  
Gold Standard ◽  
Diagnostic Value ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Measurement Results

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.

scholarly journals Traumatic Carotid-Cavernous Fistula Identified by Three-dimensional Digital Subtraction Angiography-Technical Note-

2003 ◽  
Vol 43 (7) ◽  
pp. 369-373 ◽  
Author(s):  
Fujimaro ISHIDA ◽  
Tadashi KOJIMA ◽  
Kenji KAWAGUCHI ◽  
Tamotsu HOSHINO ◽  
Kenichi MURAO ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Technical Note ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula

scholarly journals Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Güner Koyuncu Çelik ◽  
Erkan Yildirim
Keyword(s):  
Present Report ◽  
Epileptic Seizures ◽  
Digital Subtraction ◽  
Resonance Imaging ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
The Past ◽  
First Case ◽  
Eye Symptoms ◽  
Magnetic Resonance Imaging Mri

A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) imaging revealed a carotid cavernous fistula (CCF). Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report.

scholarly journals Visual impairment in high flow and low flow carotid cavernous fistula

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Md. Shahid Alam ◽  
Mukesh Jain ◽  
Bipasha Mukherjee ◽  
Tarun Sharma ◽  
Swatee Halbe ◽  
...  
Keyword(s):  
Visual Impairment ◽  
High Flow ◽  
Low Flow ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula

scholarly journals Discrepancy between two-dimensional and three-dimensional digital subtraction angiography for the planning of endovascular coiling of small cerebral aneurysms <5 mm

2020 ◽  
Vol 26 (6) ◽  
pp. 733-740
Author(s):  
Te-Chang Wu ◽  
Yu-Kun Tsui ◽  
Tai-Yuan Chen ◽  
Ching-Chung Ko ◽  
Chien-Jen Lin ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Endovascular Coiling ◽  
Parent Artery ◽  
Two Dimensional ◽  
Digital Subtraction ◽  
Rotational Angiography ◽  
Treatment Choices ◽  
The Impact

Background To investigate the discrepancy between two-dimensional digital subtraction angiography and three-dimensional rotational angiography for small (<5 mm) cerebral aneurysms and the impact on decision making among neuro-interventional experts as evaluated by online questionnaire. Materials and methods Eight small (<5 mm) ruptured aneurysms were visually identified in 16 image sets in either two-dimensional or three-dimensional format for placement in a questionnaire for 11 invited neuro-interventionalists. For each set, two questions were posed: Question 1: “Which of the following is the preferred treatment choice: simple coiling, balloon remodeling or stent assisted coiling?”; Question 2: “Is it achievable to secure the aneurysm with pure simple coiling?” The discrepancies of angio-architecture parameters and treatment choices between two-dimensional-digital subtraction angiography and three-dimensional rotational angiography were evaluated. Results In all eight cases, the neck images via three-dimensional rotational angiography were larger than two-dimensional-digital subtraction angiography with a mean difference of 0.95 mm. All eight cases analyzed with three-dimensional rotational angiography, but only one case with two-dimensional-digital subtraction angiography were classified as wide-neck aneurysms with dome-to-neck ratio < 1.5. The treatment choices based on the two-dimensional or three-dimensional information were different in 56 of 88 (63.6%) paired answers. Simple coiling was the preferred choice in 66 (75%) and 26 (29.6%) answers based on two-dimensional and three-dimensional information, respectively. Three types of angio-architecture with a narrow gap between the aneurysm sidewall and parent artery were proposed as an explanation for neck overestimation with three-dimensional rotational angiography. Conclusions Aneurysm neck overestimation with three-dimensional rotational angiography predisposed neuro-interventionalists to more complex treatment techniques. Additional two-dimensional information is crucial for endovascular treatment planning for small cerebral aneurysms.

scholarly journals Morphologic and Haemodynamic Changes after Stent Placement for Experimental Carotid Aneurysm

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 153-154 ◽  
Author(s):  
H. Tenjin
Keyword(s):  
Blood Flow ◽  
Digital Subtraction Angiography ◽  
Stent Placement ◽  
Carotid Arteries ◽  
Parent Artery ◽  
Digital Subtraction ◽  
Thin Slices ◽  
Before And After ◽  
Haemodynamic Changes ◽  
Plastic Resin

We investigated and compared the morphologic and haemodynamic changes between before and after stent placement when several different kinds of stents were applied to experimental aneurysms. Experimental aneurysms in eight pig carotid arteries were used. Stents were placed covering the aneurysm orifice. Five Cordis stents (coil stent), two GFXs (multilink stent), and one Multilink (tube stent) were used in this study. After stent placement, the arteries were perfused with 70% ethanol, the specimens were embedded in polyester plastic resin and thin slices were stained with hemtoxilin-eosin. Blood flow in the aneurysm was measured using digital subtraction angiography. The parent artery was stretched in multilink stent (GFX) cases, and was most markedly stretched by use of the tube stent (Multilink). Stent placement with any type of stent decreased intra-aneurysmal blood flow.

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