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.

scholarly journals Carotid-Cavernous Fistula in Ehlers-Danlos Syndrome by Pure Transvenous Approach

2006 ◽  
Vol 12 (1) ◽  
pp. 45-51 ◽  
Author(s):  
O. Van Overmeire ◽  
K. De Keukeleire ◽  
P. Van Langenhove ◽  
L. Defreyne
Keyword(s):  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Detachable Coils ◽  
Precautionary Measures ◽  
Transvenous Approach ◽  
Danlos Syndrome

We describe a carotid-cavernous fistula (CCF) in a middle aged woman with Ehlers-Danlos syndrome (EDS) type IV, which manifested with a left-sided ophthalmoplegia. The CCF was diagnosed on magnetic resonance imaging. To prevent potential lethal arterial wall injury, the CCF was treated endovascularly under local anesthesia and exclusively by a transvenous approach. The fistula was successfully closed with Guglielmi Detachable Coils. Notwithstanding these precautionary measures, the patient suffered an intraperitoneal and a small retroperitoneal bleed during the procedure and died suddenly ten days after intervention in hemorrhagic shock. A review of recent literature focussing on the technique of transvenous approach and the catheterization risks of CCF in Ehlers-Danlos syndrome is presented.

Republished: A novel approach to the treatment of a direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV

2014 ◽  
Vol 8 (1) ◽  
pp. e2-e2 ◽  
Author(s):  
Ichiro Nakagawa ◽  
Hun Soo Park ◽  
Takeshi Wada ◽  
Katsutoshi Takayama ◽  
Hiroyuki Nakagawa ◽  
...  
Keyword(s):  
Syndrome Type ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Novel Approach ◽  
Detachable Coils ◽  
Wall Injury ◽  
Danlos Syndrome ◽  
Direct Carotid Cavernous Fistula

We report a case of a direct carotid–cavernous fistula (CCF) in a patient with Ehlers–Danlos syndrome type IV who presented with progressive chemosis and diplopia. To prevent potential lethal arterial wall injury due to the fragility of the arterial vessel wall, the ipsilateral carotid artery and internal jugular vein were surgically exposed for direct insertion of endovascular sheaths, and transvenous embolization was performed using triple microcatheters with detachable coils. The clinical course was uneventful, and chemosis and diplopia subsequently resolved. By the 6 month follow-up, MRI revealed no recurrence of the CCF. These techniques offer a unique access alternative for endovascular treatment, thereby reducing the risks associated with arterial dissection that often accompanies transfemoral access in this particular condition.

scholarly journals A novel approach to the treatment of a direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV

2014 ◽  
Vol 2014 (nov24 1) ◽  
pp. bcr2014011414-bcr2014011414 ◽  
Author(s):  
I. Nakagawa ◽  
H. S. Park ◽  
T. Wada ◽  
K. Takayama ◽  
H. Nakagawa ◽  
...  
Keyword(s):  
Syndrome Type ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Novel Approach ◽  
Danlos Syndrome ◽  
Direct Carotid Cavernous Fistula

Balloon occlusion of a spontaneous carotid-cavernous fistula in ehlers-danlos syndrome type IV

1993 ◽  
Vol 39 (3) ◽  
pp. 187-190 ◽  
Author(s):  
Shiro Kashiwagi ◽  
Eiji Tsuchida ◽  
Katsuya Goto ◽  
Yujiro Shiroyama ◽  
Tetsuo Yamashita ◽  
...  
Keyword(s):  
Balloon Occlusion ◽  
Syndrome Type ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Danlos Syndrome

scholarly journals Carotid cavernous fistula in a patient with Ehlers-Danlos syndrome type IV: a case report

2013 ◽  
Vol 7 (2) ◽  
pp. 94-100
Author(s):  
Katsunori ASAI ◽  
Shingo TOYOTA ◽  
Kouichi HAYAKAWA ◽  
Yasunori FUJIMOTO ◽  
Fuminori IWAMOTO ◽  
...  
Keyword(s):  
Case Report ◽  
Syndrome Type ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Danlos Syndrome

Carotid-Cavernous Fistula Associated with Ehlers-Danlos Syndrome Type IV

1999 ◽  
Vol 5 (4) ◽  
pp. 313-320 ◽  
Author(s):  
Q. Bashir ◽  
J. Thornton ◽  
S. Alp ◽  
G.M. Debrun ◽  
V.A. Aletich ◽  
...  
Keyword(s):  
Underlying Disease ◽  
Syndrome Type ◽  
Review Of The Literature ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Danlos Syndrome ◽  
Direct Carotid Cavernous Fistula

A case of traumatic, direct, carotid cavernous fistula (CCF) associated with Ehlers — Danlos syndrome (EDS) Type IV is reported along with a review of the literature. Excluding the present case, three similar cases associated with EDS-TypeIV have already been reported by Gerard M. Debrun et Al1. Despite the risks associated with endovascular manipulation, the fistula was successfully closed by intravascular embolisation but the patient expired a few days later because of underlying disease-associated vascular and visceral complications.

Republished: Successful treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique

2020 ◽  
Vol 12 (11) ◽  
pp. e8-e8
Author(s):  
Thien J Huynh ◽  
Ryan P Morton ◽  
Michael R. Levitt ◽  
Basavaraj V. Ghodke ◽  
Onno Wink ◽  
...  
Keyword(s):  
Successful Treatment ◽  
Three Dimensional ◽  
Arterial Puncture ◽  
Syndrome Type ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Danlos Syndrome ◽  
Direct Carotid Cavernous Fistula

We report successful transvenous treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture.

scholarly journals Aggressive change of a carotid-cavernous fistula in a patient with Ehlers–Danlos syndrome type IV

2015 ◽  
Vol 21 (3) ◽  
pp. 341-345 ◽  
Author(s):  
Atsuhiro Kojima ◽  
Isako Saga ◽  
Ryosuke Tomio ◽  
Tomoki Kosho ◽  
Atsushi Hatamochi
Keyword(s):  
Internal Carotid ◽  
Transarterial Embolization ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Shunt Flow ◽  
Type Iv ◽  
Diagnostic Angiography ◽  
The Right ◽  
Danlos Syndrome

The authors report a rare case of a carotid-cavernous fistula (CCF) secondary to Ehlers–Danlos syndrome (EDS) type IV which showed an aggressive angiographical change. A 59-year-old woman presented with headache, right pulsatile tinnitus, and diplopia on the right side. The diagnostic angiography demonstrated a right CCF. Accordingly transarterial embolization of the fistula was attempted 5 days later. The initial right internal carotid angiography showed an aneurysm on the petrous portion of the internal carotid artery (ICA) which was not recognized in the diagnostic angiography. Spontaneous reduction of the shunt flow and long dissection of the ICA were also revealed. The aneurysm was successfully occluded with coils, and only minor shunt flow was shown on the final angiogram. EDS type IV was diagnosed with a skin biopsy for a collagen abnormality. After the operation, the stenosis of the right ICA gradually progressed, although there was no recurrence of the CCF. Interventional treatment for patients with EDS can cause devastating vascular complication. We should be aware of the possibility of EDS type IV when a spontaneous CCF shows unusual angiographical change because early diagnosis of EDS type IV is crucial for determination of the optimum treatment option.

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