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Endovascular treatment of post-traumatic direct carotid-cavernous fistulas: A single-center experience.
MedLine Citation:
PMID:  20888773     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We report our single-center experience using detachable balloons (DB), coils and Willis covered stents (MicroPort, Shanghai, China) to treat post-traumatic direct carotid-cavernous fistulas (DCCFs), focusing on preservation of the internal carotid artery (ICA). We retrospectively reviewed the records of 51 patients who received endovascular treatment (EVT). EVT with DBs was chosen as the first-line therapeutic strategy, and Willis covered stent placement and coiling was the alternative. The patency and stability of all DCCFs was evaluated by angiographic and clinical follow-up for between 3 and 48 months. A total of 54 DCCFs in 51 patients were treated as follows: DB alone (n=40); combined DB and Willis covered stent (n=8); Willis covered stent alone (n=2); combined DB and coils (n=2); coils alone (n=1); and DB in combination with both coils and a Willis covered stent (n=1). Overall, 98% of DCCFs were successfully treated with the occlusion of the fistula and preservation of the ICA; the ICA was sacrificed in only one patient. Approximately 85% of DCCFs were successfully treated with DBs alone. Second and third administrations of EVT were required in 12 DCCFs. DCCF-related symptoms improved gradually between 1 day and 6 months after treatment. EVT using DB to occlude fistulas and preserve the ICA is the preferential treatment for DCCFs. When standard treatment has failed, coils and/or Willis covered stents can be used as a safe alternative or remedial tool with ICA preservation and reconstruction.
Authors:
Wu Wang; Yong-Dong Li; Ming-Hua Li; Hua-Qiao Tan; Bin-Xian Gu; Ju Wang; Pei-Lai Zhang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia     Volume:  18     ISSN:  1532-2653     ISO Abbreviation:  J Clin Neurosci     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9433352     Medline TA:  J Clin Neurosci     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  24-8     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai 200233, China.
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