Treatment of posttraumatic carotid-cavernous fistula using a detachable balloon catheter

1980 ◽  
Vol 53 (6) ◽  
pp. 784-786 ◽  
Author(s):  
Aldo Benati ◽  
Adriano Maschio ◽  
Stefano Perini ◽  
Alberto Beltramello

✓ Five cases of posttraumatic carotid-cavernous fistula are reported. The fistulas were occluded by intravascular detachable balloons, as described by Serbinenko and later modified by Debrun. The good results obtained in three of these patients illustrate the value of this procedure, as it allows a direct obliteration of the fistula with preservation of the internal carotid blood flow.

1974 ◽  
Vol 41 (6) ◽  
pp. 657-670 ◽  
Author(s):  
Sean Mullan

✓ The results of 61 cases of stereotaxic thrombosis of intracranial berry aneurysms indicate that the technique in selected cases is comparable to, but not necessarily superior to standard surgical methods. The results of wire-induced thrombosis in 15 cases of giant intracranial aneurysm suggest that this method is effective in situations where clipping and encapsulation are inapplicable. The results of thrombosis in six cases of carotid cavernous fistula suggest that intracavernous wire thrombosis may prove to be the treatment of choice in that it seals the fistula without impairing carotid blood flow.


1973 ◽  
Vol 38 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Perry Black ◽  
Sumio Uematsu ◽  
Milos Perovic ◽  
A. Earl Walker

✓ A case is described in which a carotid-cavernous fistula was eliminated successfully with preservation of the carotid circulation by a small ball-shaped muscle embolus introduced via an arteriotomy in the cervical carotid. The intent is to lodge the embolus in the fistula without occluding the carotid siphon. A long thread is attached to the embolus to permit its withdrawal if its position in the siphon proves unsatisfactory. Neither the intracranial nor cervical carotid artery is ligated.


1983 ◽  
Vol 59 (6) ◽  
pp. 1076-1081 ◽  
Author(s):  
Brian M. Tress ◽  
Kenneth R. Thomson ◽  
Geoffrey L. Klug ◽  
Roger R. B. Mee ◽  
Bruce Crawford

✓ Two cases of carotid-cavernous fistulas were successfully treated by standard interventional radiology techniques after otherwise inaccessible vessels were surgically exposed. In the first case, an internal carotid artery (ICA), which had previously been ligated as part of an attempted surgical “entrapment” procedure, was recanalized to permit passage of a detachable balloon catheter to the fistula, resulting in its obliteration. In the second case, an enlarged superior ophthalmic vein was exposed and isolated to facilitate retrograde catheterization of the cavernous sinus and obliteration of a dural fistula between the ICA and the cavernous sinus by steel Gianturco coils. The methods and complications of both procedures are discussed.


1984 ◽  
Vol 61 (2) ◽  
pp. 402-404
Author(s):  
John P. Kapp ◽  
Joga R. Pattisapu ◽  
J. Larry Parker

✓ A carotid-cavernous fistula which had recurred after trapping, embolization, intracranial packing with muscle, and excision of the cervical carotid bifurcation was successfully closed with a Fogarty catheter introduced through the fibrous remnant of the cervical internal carotid artery.


1976 ◽  
Vol 44 (3) ◽  
pp. 347-352 ◽  
Author(s):  
F. Hermann Rudenberg ◽  
C. Patrick McGraw ◽  
George T. Tindall

✓ The combined effect upon cerebral blood flow (CBF) of an elevation of cerebrospinal fluid pressure (CSFP) and changes in respiratory CO2 was studied in nine baboons under chloralose anesthesia. The animals were mildly hyperventilated and provided with increasing amounts of CO2 in O2-air. Arterial CO2 tensions (PaCO2) increased from 17 to 58 mm Hg. Internal carotid blood flow (ICBF) was measured at normal CSFP and at hydrostatically maintained 50 mm Hg CSFP. It was found that: 1) end-tidal CO2 may be used as a substitute for arterial PaCO2 determinations; 2) this elevation of CSFP has little effect on ICBF during hypercapnia and normocapnia; however, 3) during hypocapnia the ICBF is reduced an additional 20% when CSFP is elevated; that is, ICBF is reduced 50% from normal when end-tidal CO2 is reduced to 2% at this elevated level of CSFP. Caution should be exercised during hyperventilation therapy particularly if the elevated CSFP or intracranial pressure (ICP) is not reduced to approach normal levels; in these conditions, the combination of decreasing PaCO2 and elevated ICP may reduce CBF below critical levels and thus lead to cerebral hypoxia.


1984 ◽  
Vol 60 (5) ◽  
pp. 1080-1084 ◽  
Author(s):  
Ibrahim A. Sbeih ◽  
Sean A. O'Laoire

✓ The authors report a case of a high-flow posttraumatic carotid-cavernous fistula, with complete steal of the blood flow from the ipsilateral internal carotid artery (ICA). Direct attack on the intracavernous carotid artery was performed using the approach of Parkinson with temporary isolation of the ICA. Complete transection of the artery within the cavernous sinus was encountered. The fistula was occluded by clipping the two ends of the ICA within the sinus. The implications of this previously unreported finding are discussed.


2003 ◽  
Vol 98 (5) ◽  
pp. 1116-1119 ◽  
Author(s):  
Stanley H. Kim ◽  
Adnan I. Qureshi ◽  
Alan S. Boulos ◽  
Bernard R. Bendok ◽  
Elad I. Levy ◽  
...  

✓ The authors report a case of an iatrogenic carotid—cavernous fistula (CCF) associated with intracranial angioplasty. Angioplasty was performed using a 3 × 10-mm Open Sail coronary balloon in a patient with high-grade stenosis of the left cavernous internal carotid artery (ICA). After angioplasty, a perforation developed in the cavernous ICA, resulting in a CCF. A 3.5 × 9—mm S670 coronary stent was used to treat the fistula. To the authors' knowledge, this is the first reported case in which a CCF developed after angioplasty was performed using a coronary balloon. Long-term angiographic and clinical evaluation is needed to test the suitability and durability of intracranial angioplasty and stent placement in the treatment of symptomatic intracranial stenosis.


1981 ◽  
Vol 55 (5) ◽  
pp. 813-818 ◽  
Author(s):  
S. V. Ramana Reddy ◽  
Thoralf M. Sundt

✓ A case of giant traumatic false aneurysm of the intracranial internal carotid artery (ICA) with a concomitant carotid-cavernous fistula is reported. The fistula and the aneurysm persisted after ipsilateral cervical ICA ligation was performed elsewhere. Successful obliteration of the aneurysm and the fistula, with preservation of cross filling of the ipsilateral middle cerebral artery system, was accomplished by ligation of the intracranial ICA proximal to the origin of the posterior communicating artery with a 7–0 prolene suture, followed by transaneurysmal packing of the fistula.


1975 ◽  
Vol 42 (1) ◽  
pp. 76-85 ◽  
Author(s):  
Yoshio Hosobuchi

✓ The author describes a technique for directly closing a carotid cavernous fistula with electrothrombosis while preserving the intracranial arterial circulation. Copper wires are introduced through the superior ophthalmic vein or a frontotemporal craniotomy, and thus directly into the portion of the sinus into which the fistula drains; if posterior, into the posterior segment of Parkinson's triangle, if inferior, into the pterygoid plexus, and if anterior, through the sphenoparietal sinus and/or middle cerebral vein to the anterior-inferior portion of the sinus. A direct current is applied until a thrombus is confirmed angiographically and the wires are left in place. Four patients treated by this method are presented.


1983 ◽  
Vol 59 (3) ◽  
pp. 524-528 ◽  
Author(s):  
Thomas J. Leipzig ◽  
Sean F. Mullan

✓ A carotid-cavernous fistula was occluded by a detachable latex balloon. Because of technical problems, the contrast-filled balloon was left in a precarious position in the ostium of the fistula. Premature deflation of the balloon would have resulted in intra-arterial migration of the device. Approximately 1 week is required for the balloon to become secured in place by fibrous attachment to the vascular wall. For success, if the ligature is adequate, a detachable Debrun balloon should remain inflated for this period of time. The deflation process was monitored radiographically in this patient. The balloon remained inflated for at least 2 weeks. A short summary of the experience with deflation of various contrast-containing balloon devices in the treatment of carotid-cavernous fistulas is given. Metrizamide may be the best contrast agent for use in these devices.


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