Patients with dural carotid cavernous fistulas: clinical data and endovascular techniques
| Patient No./Age (y)/Sex | Clinical Presentation | Type* | Approach | Embolic Material | Angiography Obliteration† | Clinical Outcome | Complications |
|---|---|---|---|---|---|---|---|
| 1/41/F | Chemosis, proptosis | D | SOV percutaneous/IPS/IMAX | n-BCA (TV), PVA (IMAX) | Yes | Cure | n-BCA droplet escaped via the fistula into MCA, no branch occlusion; no clinical sequelae |
| 2/70/M | Chemosis, decreased visual acuity | B | SOV percutaneous | n-BCA (TV) | Yes | Cure | No |
| 3/56/M | Chemosis, ophthalmoplegia | D-2 | IPS transfemoral | n-BCA (TV) | Yes | Cure | Initial worsening of cranial nerve VI palsy, but progressive improvement |
| 4/87/F | Chemosis, decreased visual acuity, ophthalmoplegia | D-2 | SOV transfemoral | n-BCA (TV) | Yes | Cure | n-BCA spillage into SOV without clinical sequelae |
| 5/45/M | Chemosis, proptosis, decreased visual acuity | D-2 | SOV transfemoral IMAX | Coils/n-BCA (TV), n-BCA (TA) | Yes | Cure | Microcatheter perforation of IPS, no sequelae |
| 6/93/F | Chemosis, pain | B | IPS transfemoral | Coils/n-BCA (TV) | Yes | Cure | No |
| 7/82/M | Chemosis | B | IPS transfemoral | n-BCA (TV) | Yes | Cure | No |
| 8/35/F | Chemosis, ophthalmoplegia | C | IPS transfemoral IMAX | Coils/n-BCA (TV), n-BCA (IMAX) | Yes | Cure | No |
| 9/54/M | Chemosis, proptosis | B | IPS transfemoral | n-BCA (TV) | Yes | Cure | No |
| 10/91/F | Chemosis, proptosis, ophthalmoplegia | C-2 | IPS transfemoral | Coils n-BCA (TV) | Yes | Cure | No |
| 11/60/F | Chemosis, proptosis, ophthalmoplegia | D-2 | IPS transfemoral | Coils in SOV n-BCA (TV) | Yes | Cure | No |
| 12/65/F | Chemosis, proptosis, ophthalmoplegia | D | IPS transfemoral | Coils in SOV n-BCA (TV) | Yes | Cure | No |
| 13/60/F | Chemosis, proptosis | D | IPS transfemoral | n-BCA (TV) | Yes | Cure | No |
| 14/44/M | Chemosis, proptosis | D | IPS transfemoral | Coils/balloon-assisted n-BCA (TV) | Yes | Cure | No |
Note.—C-2 indicates bilateral; D-2, bilateral; IPS, inferior petrosal sinus; n-BCA, n-butyl-cyanoacrylate; SOV, superior ophthalmic vein; TA, transarterial; TV, transvenous; IMAX, internal maxillary artery.
* From Barrow et al (2).
† Patient no. 3 had a follow-up angiography because of an initial worsening of symptoms, but demonstrated obliteration. Patients nos. 6 and 9 had tiny residual filling of the dCCF as seen on immediate posttreatment angiograms, but showed obliteration at 6-month follow-up study.