Document Detail

Endovascular treatment strategy for direct carotid-cavernous fistulas resulting from rupture of intracavernous carotid aneurysms.
MedLine Citation:
PMID:  14561604     Owner:  NLM     Status:  MEDLINE    
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.
Nozomu Kobayashi; Shigeru Miyachi; Makoto Negoro; Osamu Suzuki; Koji Hattori; Takao Kojima; Jun Yoshida
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  24     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-16     Completed Date:  2004-01-08     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1789-96     Citation Subset:  IM    
Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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MeSH Terms
Aged, 80 and over
Aneurysm, Ruptured / complications*,  diagnosis,  therapy
Carotid Artery Diseases / complications*,  diagnosis,  therapy
Carotid Artery, Internal / pathology,  radiography
Carotid-Cavernous Sinus Fistula / diagnosis,  etiology,  therapy*
Embolization, Therapeutic*
Intracranial Aneurysm / complications*,  diagnosis,  therapy
Magnetic Resonance Angiography
Middle Aged

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