Comparison of polyvinyl alcohol copolymer with detachable balloons for the embolisation of direct carotid cavernous fistula: a single-centre experience

He, Xiaofu; Duan, Chuan‐Zhi; Lai, Lingfeng; Zhang, Xin; Li, Zhenjun; Li, Tielin

doi:10.1007/s00330-017-4864-2

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…After direct comparison with other techniques widely used in literature for CCF occlusion, FDDs in combination with other embolizing materials offer a lower immediate occlusion rate, but comparable if not better long-term occlusion rates and clinical improvement. 31–35 Arifin et al. presented a case series with 100% immediate occlusion rate of CS coiling, while embolization using detachable balloons was 40%.…”

Section: Discussionmentioning

confidence: 99%

“…reported that in 105 cases of CCFs treated with detachable balloon or polyvinyl alcohol copolymer, occlusion rates ware 96,5% and 84,2% respectively, but with some major complications, including death. 35 Moreover, Ertl et al. using a combination of endovascular techniques without FDD, reported a complication rate of 8% and long-term follow up occlusion rate of 96%.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of carotid cavernous sinus fistulas with flow diverters. A case report and systematic review

et al. 2021

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Introduction Carotid cavernous fistulas (CCFs) are rare, usually follow head trauma or aneurysmal rupture. Recent treatment options include endovascular techniques such as flow diversion devices (FDDs). Objective To present our case treated with FDD application with transarterial cavernous-sinus coiling and present a systematic review on the use and effectiveness of FDDs in CCF treatment. Materials and methods We present our case of CCF treatment with FDD. A search was also conducted in PubMed, EMBASE and Cochrane until November 2020. Reference lists were also cross-checked. Results Including our case, thirty-eight patients were identified with a CCF that was treated with FDDs in sixteen studies. Twenty-two patients were females, nine were males and the rest unidentified. The mean age was 52,6 years (range 17–86, SD± 19.28). Thirty-six patients suffered from direct and two from indirect CCFs. Single FDD was used in four cases, single FDD with embolic materials in eleven cases, multiple overlapping FDDs were used in six cases and multiple overlapping FDDs with embolic materials were used in seventeen cases. Thirty-five patients (92,1%) had clinical improvement, immediate angiographic occlusion was seen in 44,7% of the cases, while long-term occlusion rate was 100% but with variable follow-up periods. One patient (2,6%) presented with a neurological deficit related to FDD deployment. Conclusion Targeted treatment of CCFs with single or overlapping FDDs with or without adjunct embolic agents offers a high success rate, both clinically and long-term angiographically compared to other endovascular methods alone. However, further research with multi-center prospective trials is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of carotid cavernous sinus fistulas with flow diverters. A case report and systematic review

et al. 2021

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“…From the economical perspective, detachable balloons are much cheaper than coils combined with liquid embolism in china with comparable complete occlusion rate and recanalization rate [ 21 ]. Others reported a higher recanalization rate of detachable balloons [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up

Liu

Wang

et al. 2021

Chin Neurosurg Jl

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Background Willis covered stent is the first stent designed exclusively for intracranial vasculature, and its application in carotid-cavernous fistula is limited. The aim is to evaluate the feasibility and efficacy of this device in treating direct carotid-cavernous fistula. Methods Ten consecutive patients with direct carotid-cavernous fistula were treated in our institution with Willis covered stents from September 2013 to December 2015. The characteristics of these patients and the immediate and follow-up results were retrospectively reviewed. Results Of the 10 patients, 8 were treated for the first time, and 2 had been treated elsewhere. Willis covered stents were successfully released in 9 patients. Abnormal arteriovenous shunt disappeared in 6 cases immediately after stent deployment and endoleak occurred in 3 cases. Endoleak disappeared at 6-month angiography follow-up in one case and was sealed with coils through a pre-set microcatheter in another case. Parent artery was sacrificed as endoleak remained despite repeated balloon dilation and a second stent deployment in the third case. All patients got clinical follow-ups for at least 24 months and 7 patients received angiographic follow-up. Symptoms were relieved gradually in all cases except for slight oculomotor paralysis and visual acuity in one case, respectively. In-stent stenosis was found in 1 case, and no recurrence was observed. Conclusions Willis covered stent is feasible for direct carotid-cavernous fistula.

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“…In literature, several cases are described where glue, onyx, or polyvinyl alcohol (PVA) particles were used by the interventionist in combination with detachable coils to adequately pack the fistula with variable results. 17 18 Using liquid/particle embolizing agents for these high-flow conditions carry a high-complication rate like nontarget embolization of cortical veins or an arterial embolic stroke. 17 18 We did not use liquid or particle agents for direct CCF embolization in any of our cases.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Direct Carotid–Cavernous Fistula: Evolution of Cost Effective Sandwich Technique

Prasad

Singh

Boruah

et al. 2020

JNRP

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Objective There is a direct fistulous connection between the cavernous segment of the internal carotid artery and cavernous sinus in cases of direct carotid–cavernous fistula (CCF). Endovascular embolization is the mainstay of management in this condition. This study is about the evolution of endovascular treatment methods and the development of a cost-effective technique for embolization of direct CCF at a tertiary care center. Materials and Methods A retrospective analysis was performed of all the cases of direct type CCF embolized by endovascular techniques in our department from 2008 to 2018.Clinical follow-up of these patients was done at 1 week, 3 months, and 6 months. Results A total of 45 patients with 40 having a prior history of head trauma were included in this study. All cases were treated with a transarterial route except one which was treated with the transvenous approach. Detachable balloons were used in 12 (26.67%) patients, only detachable coils in 14 cases (31.11%), both detachable balloons and coils in 9 cases (20%), and both detachable and push coils, that is, sandwich technique in 8 cases (17.78%). Parent arterial occlusion was performed in 10 patients (22.22%). There was complete resolution of chemosis and bruit in all the patients. Conclusions Endovascular treatment is the mainstay of management in direct CCF. Using more fibered thrombogenic coils in a sandwich manner decreases the cost of the treatment significantly.

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Comparison of polyvinyl alcohol copolymer with detachable balloons for the embolisation of direct carotid cavernous fistula: a single-centre experience

Cited by 4 publications

References 13 publications

Treatment of carotid cavernous sinus fistulas with flow diverters. A case report and systematic review

Treatment of carotid cavernous sinus fistulas with flow diverters. A case report and systematic review

Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up

Endovascular Management of Direct Carotid–Cavernous Fistula: Evolution of Cost Effective Sandwich Technique

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