Artificial Embolic Occlusion of the Terminal Internal Carotid Artery in the Treatment of Carotid-Cavernous Fistula

Kosary, I. Z.; Lerner, M. A.; Mozes, M; Lazar, Martin L.

doi:10.3171/jns.1968.28.6.0605

Cited by 21 publications

(4 citation statements)

References 5 publications

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“…Lang and Bucy (1965) successfully repeated this technique but without ligation of the internal carotid artery, although it was followed by thrombosis of this artery. Kosary et al (1968) used porcelain beads as the embolic material in one patient but again they ligated the cervical internal carotid artery.…”

Section: Discussionmentioning

confidence: 99%

“…Since then a limited number of artificial embolizations with surgical (Hamby and Gardner, 1933; Gurdjian, 1938;Rottgen, 1948;Jaeger, 1949;Jaeger, 1959;Sunder-Plassmann and Tiwisina, 1952;Hamby, 1964;674 Hamby, 1966;Kosary, Lerner, Mozes, and Lazar, 1968;Arutiunov, Serbinenko, and Shlykov, 1968) or accidental (Lang and Bucy, 1965) occlusion of the internal carotid artery in the neck, preceded in some with an intracranial carotid clipping, have been reported. Nonetheless all of these reported cases had a reduction of the ipsilateral carotid flow either due to the internal carotid ligation following the embolization or to post-operative carotid thrombosis.…”

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confidence: 99%

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Artificial embolization of carotid-cavernous fistula with post-operative patency of internal carotid artery

Isamat

Salleras

Miranda

1970

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY This report deals with a patient of 86 who developed a carotid-cavernous fistula. Artificial embolization alone was considered the safest treatment for this patient and proved to be adequate. Post-operative preservation of the patency of the internal carotid artery was demonstrated by angiography. We believe this method is particularly appropriate for carotid-cavernous fistulas if it is demonstrated by angiography that the major blood flow of the carotid artery pours into the fistula. A soft-iron clip attached to the muscle can be used for external and forceful guidance of the embolus into the fistula with the help of an electromagnet, hence the patency of the internal carotid artery can be preserved. The embolus should be introduced through the external carotid artery. This is the only case known to us in which patency of the internal carotid artery was postoperatively maintained. We have reviewed 545 reported cases of surgically treated carotid-cavernous fistulas and analysed the results from simple cervical carotid ligation to the more sophisticated methods of artificial embolizations. The results obtained by artificial embolization have been consistently good, while the other techniques have failed in large percentages. Artificial embolization should be used as the primary treatment for carotid-cavernous fistula, since ligation of the internal carotid artery precludes its embolization at a later date.Because of the dramatic and intense disability produced by a carotid-cavernous fistula this intracranial vascular pathology has had considerable surgical attention in spite of the low rate of incidence. A variety of surgical techniques have been developed but most of the surgical approaches have dealt with a distant reduction of the blood flow into the fistulous tract rather than with the closure of the fistula itself. Examples are the single or combined ligation of the carotid arteries in the neck and isolation of the fistula between an intracranial carotid clip and a cervical carotid ligation, the so-called 'trapping' operation.The first attempt to treat a carotid-cavernous fistula with a physiological approach to the problem was that of Brooks (1930) who successfully performed a muscle embolization of the intracavernous portion of the carotid artery. Since then a limited number of artificial embolizations with surgical (Hamby

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Artificial embolization of carotid-cavernous fistula with post-operative patency of internal carotid artery

Isamat

Salleras

Miranda

1970

Journal of Neurology, Neurosurgery & Psychiatry

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“…Most subsequent authors of that time all quote ‘Brooks' method of muscle embolization.’ Sedzimir and Occleshaw15 ‘operation of muscle embolization — Brooks' method.’ Ishimori et al 16 state that ‘Brooks was considered to be the first to have carried out occlusion of the carotid-cavernous fistula with thrombus-making material.’ Kosary et al 17 quote ‘successful treatment of a case by muscle embolization alone by Brooks.’ Arutinnov et al 18: ‘Original Brooks operation has one important drawback: the muscular embolus is not controlled.’ Riechert,19 ‘Introduction of a small embolus of muscle after Brooks.’ Wanissorn20 quotes ‘The intraluminal embolization method of Brooks.’…”

Section: Pre-balloon Eramentioning

confidence: 99%

The myth of the Brooks method of embolization: a brief history of the endovascular treatment of carotid–cavernous sinus fistula

Vitek

Smith

2009

J NeuroIntervent Surg

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“…For this reason, embolic material is not "sucked into" the malformation; spinal angi- omas do not exert the vortex or sump effect that Luessenhop,et al,[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] have used to advantage in embolizing cerebral angiomas. Therefore, it is often necessary to deliberately occlude the parietal branches of an intercostal or lumbar artery before the branch supplying the spinal malformation can b e successfully embolized.…”

Section: Theoretical and Technical Considerationsmentioning

confidence: 99%

Percutaneous embolization of spinal cord arteriovenous malformations

Jl¹,

G²,

Ak³

1971

Journal of Neurosurgery

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~' A technique is described for embolically occluding the feeding arteries of spinal cord arteriovenous malformations by non-operative means. Following the identification of each feeder by selective arteriography, a system of coaxial catheters is introduced percutaneously and each feeding artery is occluded within the spinal canal using metallic pellets, gelfoam, and muscle fragments. Technical details of the procedure are described and the choice of embolic material discussed. Embolization has been successfully accomplished in five patients. None were made worse, and three have shown progressive neurological improvement. The simplicity of the procedure and the absence of morbidity are stressed. Percutaneous embolization should be considered as an alternative to operative ligation of feeding arteries. KEY WORDS arteriography spinal cord arteriovenous malformation spinal cord spinal cord angioma transcatheter embolization ,48 J. Neurosurg. /

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Artificial Embolic Occlusion of the Terminal Internal Carotid Artery in the Treatment of Carotid-Cavernous Fistula

Cited by 21 publications

References 5 publications

Artificial embolization of carotid-cavernous fistula with post-operative patency of internal carotid artery

Artificial embolization of carotid-cavernous fistula with post-operative patency of internal carotid artery

The myth of the Brooks method of embolization: a brief history of the endovascular treatment of carotid–cavernous sinus fistula

Percutaneous embolization of spinal cord arteriovenous malformations

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