Document Detail


Transarterial balloon-assisted n-butyl-2-cyanoacrylate embolization of direct carotid cavernous fistulas.
MedLine Citation:
PMID:  16908575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Transarterial detachable balloon embolization of direct carotid cavernous fistulas (DCCFs) has become an optimal treatment. In a few cases, the parent artery has to be sacrificed to achieve morphologic cure. We present our experience with transarterial balloon-assisted n-butyl-2-cyanoacrylate (n-BCA) embolization of DCCFs in which there was failure to achieve angiographic cure and preservation of parent arteries. METHODS: Of 141 patients with traumatic DCCFs who had been treated by transarterial embolization with occlusion of the fistula and parent artery preservation, 18 received transarterial balloon-assisted n-BCA embolization-6 for residual fistula after the balloons detached, 7 for recurrent fistula because of premature balloon deflation or migration, and 5 for repeated puncture of the detachable balloon by the bony fragment at the cavernous sinus. A total of 27 procedures were performed with an average 1.5 attempts per patient, and the volume of the n-BCA mixture varied from 0.5 to 2.3 mL with a mean of 0.83 mL. RESULTS: All DCCFs were successfully occluded by the n-BCA mixture with preservation of parent arteries. One patient with a giant cavernous sinus varix had a fatal subarachnoid hemorrhage. One had a recurrence and was treated by internal carotid artery (ICA) occlusion. Five had asymptomatic pseudoaneurysms at the parent artery. There was no adhesion of the n-BCA mixture to the protective balloon or the microcatheter or n-BCA reflux into the parent arteries. CONCLUSION: Transarterial balloon-assisted n-BCA embolization is a feasible, efficient, and safe treatment for DCCFs when angiographic cure and ICA preservation are not achieved by transarterial detachable balloon embolization.
Authors:
C-B Luo; M M H Teng; F-C Chang; C-Y Chang
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  27     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-15     Completed Date:  2006-09-29     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:  1535-40     Citation Subset:  IM    
Affiliation:
Department of Radiology, Taipei Veterans General Hospital, No. 201 Section 2 Shih-Pai Road, Beitou, Taipei 112, Taiwan, R.O.C. cbluo@vghtpe.gov.tw
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, False / etiology
Balloon Dilatation / methods*
Carotid Artery, Internal / pathology,  radiography
Carotid-Cavernous Sinus Fistula / radiography,  therapy*
Embolization, Therapeutic / instrumentation,  methods*
Enbucrilate / administration & dosage,  therapeutic use*
Feasibility Studies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Recurrence
Retreatment
Safety
Subarachnoid Hemorrhage / etiology
Tissue Adhesives / administration & dosage,  therapeutic use*
Treatment Outcome
Varicose Veins / therapy
Chemical
Reg. No./Substance:
0/Tissue Adhesives; 6606-65-1/Enbucrilate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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