FIG 3. Case 3.

A and B, Left carotid angiograms show a high-flow CCF (A). Shunt flow is nearly obliterated by a detachable balloon, but the orifice is too large to permit complete obliteration. In addition, the space between the orifice and the wall of cavernous sinus is too small to safely position a sufficiently inflated balloon at the fistula (B); further inflation of the balloon can result in migration into the parent artery. Therefore, parent artery occlusion was performed after confirming cross flow with a test occlusion.