Patients with dural carotid cavernous fistulas: clinical data and endovascular techniques

Patient No./Age (y)/SexClinical PresentationType*ApproachEmbolic MaterialAngiography ObliterationClinical OutcomeComplications
1/41/FChemosis, proptosisDSOV percutaneous/IPS/IMAXn-BCA (TV), PVA (IMAX)YesCuren-BCA droplet escaped via the fistula into MCA, no branch occlusion; no clinical sequelae
2/70/MChemosis, decreased visual acuityBSOV percutaneousn-BCA (TV)YesCureNo
3/56/MChemosis, ophthalmoplegiaD-2IPS transfemoraln-BCA (TV)YesCureInitial worsening of cranial nerve VI palsy, but progressive improvement
4/87/FChemosis, decreased visual acuity, ophthalmoplegiaD-2SOV transfemoraln-BCA (TV)YesCuren-BCA spillage into SOV without clinical sequelae
5/45/MChemosis, proptosis, decreased visual acuityD-2SOV transfemoral IMAXCoils/n-BCA (TV), n-BCA (TA)YesCureMicrocatheter perforation of IPS, no sequelae
6/93/FChemosis, painBIPS transfemoralCoils/n-BCA (TV)YesCureNo
7/82/MChemosisBIPS transfemoraln-BCA (TV)YesCureNo
8/35/FChemosis, ophthalmoplegiaCIPS transfemoral IMAXCoils/n-BCA (TV), n-BCA (IMAX)YesCureNo
9/54/MChemosis, proptosisBIPS transfemoraln-BCA (TV)YesCureNo
10/91/FChemosis, proptosis, ophthalmoplegiaC-2IPS transfemoralCoils n-BCA (TV)YesCureNo
11/60/FChemosis, proptosis, ophthalmoplegiaD-2IPS transfemoralCoils in SOV n-BCA (TV)YesCureNo
12/65/FChemosis, proptosis, ophthalmoplegiaDIPS transfemoralCoils in SOV n-BCA (TV)YesCureNo
13/60/FChemosis, proptosisDIPS transfemoraln-BCA (TV)YesCureNo
14/44/MChemosis, proptosisDIPS transfemoralCoils/balloon-assisted n-BCA (TV)YesCureNo
  • 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.