J Korean Neurosurg Soc.  2009 Dec;46(6):572-576. 10.3340/jkns.2009.46.6.572.

Endovascular Graft-Stent Placement for Treatment of Traumatic Carotid Cavernous Fistulas

• Choi BJ
• Lee TH
• Kim CW
• Choi CH

• KMID: 2190212
• DOI: http://doi.org/10.3340/jkns.2009.46.6.572

Abstract

Detachable balloon-based endovascular fistula occlusion is a widely accepted treatment for traumatic carotid cavernous fistulas (CCF). However, more recently coils have been used to obliterate the lesion, especially in case detachable balloon is not available. We failed balloon-assisted coil embolization for CCF because of large fistulas and herniation of coil loops into the parent artery. The authors describe our experiences of balloonexpandable graft-stents to treat CCF, and place emphasis on arterial wall reconstruction. Three traumatic CCF patients were treated using a graft-stent with/without coils, and underwent angiographic follow-up to evaluate the patency of the internal carotid artery (ICA). In all cases, symptoms related to CCF regressed after stent deployment and did not recur during follow-up. Follow-up angiography revealed good patency of the ICA in all patients. Graft-stents should be considered as an alternative means of treating CCF and preserving the parent artery by arterial wall reconstruction especially in patients with a fistula that cannot be successfully occluded with detachable balloons or coils.

Keyword

Carotid cavernous fistulas; Graft-stent; Endovascular treatment

MeSH Terms

Angiography
Arteries
Carotid Artery, Internal
Caves
Fistula
Follow-Up Studies
Humans
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia
Parents
Stents
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia