Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kobayashi, N. Articles by Yoshida, J. Search for Related Content PubMed PubMed Citation Articles by Kobayashi, N. Articles by Yoshida, J.

American Journal of Neuroradiology 24:1789-1796, October 2003
© 2003 American Society of Neuroradiology

INTERVENTIONAL

Endovascular Treatment Strategy for Direct Carotid-Cavernous Fistulas Resulting from Rupture of Intracavernous Carotid Aneurysms

Nozomu Kobayashi^a, Shigeru Miyachi^a, Makoto Negoro^a, Osamu Suzuki^a, Koji Hattori^a, Takao Kojima^a and Jun Yoshida^a

^a From the Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

Address reprint requests to Shigeru Miyachi, MD, Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan

BACKGROUND AND PURPOSE: Reported treatments and outcomes in aneurysmal carotid-cavernous fistulas (CCFs) have been admixed with those of cases considered to be symptomatic of intracavernous aneurysm. However, aneurysmal CCFs have clinical features distinct from those of dural arteriovenous fistulas, and treatment strategies similar to those of traumatic CCF are required. We evaluated our experience in placing detachable balloons in the management of spontaneous CCFs due to rupture of an intracavernous aneurysm.

METHODS: Six patients (one man, five women; mean age, 64.7 years) were treated for spontaneous direct CCF at our institution between 1995 and 2001. All patients presented with sudden ocular symptoms including exophthalmos, conjunctival injection, chemosis, and ocular motor palsies. Detachable latex balloons were used as the embolic material in five patients, and in one patient the cavernous sinus was packed transarterially with coils.

RESULTS: All six patients were successfully treated by means of transarterial embolization, and symptoms improved within a week.

CONCLUSION: Although other techniques using a transvenous approach and/or detachable coils may also be useful, embolization with detachable balloons should be a safe and effective method to immediately occlude the fistula.

This article has been cited by other articles:

				E. Archondakis, G. Pero, L. Valvassori, E. Boccardi, and G. Scialfa Angiographic Follow-Up of Traumatic Carotid Cavernous Fistulas Treated with Endovascular Stent Graft Placement AJNR Am. J. Neuroradiol., February 1, 2007; 28(2): 342 - 347. [Abstract] [Full Text] [PDF]

				W.J. van Rooij, M. Sluzewski, and G.N. Beute Ruptured Cavernous Sinus Aneurysms Causing Carotid Cavernous Fistula: Incidence, Clinical Presentation, Treatment, and Outcome AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 185 - 189. [Abstract] [Full Text] [PDF]