Persistent Trigeminal Artery with a Cerebellar Branch and Trigeminal-Cavernous Fistula from Ruptured Aneurysm: Transarterial Coil Embolization

A 59-year-old man who denied a history of trauma presented with left pulsatile tinnitus and left orbital swelling for six months. Digital subtraction angiography showed a left persistent trigeminal artery (PTA) with a trigeminal artery to cavernous sinus (trigeminal-cavernous sinus) fistula and a right PTA. Transarterial detachable coil embolization of the left trigeminal-cavernous sinus fistula was performed, and the symptoms subsided. There has been no report of bilateral PTAs with a spontaneous fistula connected from one PTA to the ipsilateral cavernous sinus. This paper reports such a rare circumstance.

Download Full-text

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

Indian Journal of Neurosurgery ◽

10.4103/2277-9167.94375 ◽

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.

Download Full-text

Post-Traumatic Cavernous Fistula Fed by Persistent Trigeminal Artery: Treatment by GDC Embolisation

Interventional Neuroradiology ◽

10.1177/159101990100700107 ◽

2001 ◽

Vol 7 (1) ◽

pp. 47-50 ◽

Cited By ~ 3

Author(s):

P.S. Deol ◽

N.K. Mishra ◽

V. Gupta ◽

S.B. Gaikwad ◽

A. Garg ◽

...

Keyword(s):

Cavernous Sinus ◽

Posterior Circulation ◽

Persistent Trigeminal Artery ◽

Trigeminal Artery ◽

Cavernous Fistula ◽

Persistent Primitive Trigeminal Artery ◽

Balloon Embolisation ◽

Post Traumatic ◽

Primitive Trigeminal Artery

A case of traumatic persistent primitive trigeminal artery (PPTA) cavernous sinus fistula treated with GDC embolisation is reported. Because of the small lumen of PPTA, posteriorly directed course and flow contribution from the posterior circulation, balloon embolisation via the carotid system was not considered appropriate. The fistula was successfully closed by GDC embolisation.

Download Full-text