J Korean Radiol Soc.  1989 Oct;25(5):659-666. 10.3348/jkrs.1989.25.5.659.

Treatment of traumatic carotid-cavernous fistulas using detachable balloons

• Han MH
• Han JK
• Chang KH

• KMID: 2359042
• DOI: http://doi.org/10.3348/jkrs.1989.25.5.659

Abstract

Since the introduction of the concept of detachable balloon technique to occlude arteriovenous fistulas, thistechnique has become the treatment of choice in the management of traumatic carotid cavernous fistulas (CCF). Wetried the occlusion of fistula using detachable balloons in 30 consecutive cases of traumatic CCF and the resultof our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases andthe fistulas were successfully occluded in 28 cases of all. In 20 cases, internal carotid artery was preserved andthe arterial lumen was occluded along with fistlua opening in 9 cases. In rest of 2 cases, surgical ligation wasdone because of procedure-related thromboembolism and incomplete occlusion of fistula. We experienced hemiparesisas a major complication in 3 cases. In one of them, the symptom developed during occlusion tolerance test, onejust after insertion of guiding catheter into the internal carotid artery, and in one case 2 days after theocclusion of internal carotid artery. In one case, the procedure was performed by the direct puncture of carotidartery because of the ligation of common carotid artery by previous surgery. It is suggested that the systemicheparinization during the procedure is indispensible and starting the procedure with No.9 balloon is considered reasonable.

MeSH Terms

Arteriovenous Fistula
Carotid Artery, Common
Carotid Artery, Internal
Catheters
Fistula*
Latex
Ligation
Punctures
Thromboembolism
Latex