Internal carotid artery occlusion may affect long-term quality of life in patients with high-flow carotid cavernous fistulas

Dai, Rongqin; Bai, Weixing; Gao, Bu-Lang; Li, Tianxiao; Zhang, Kun

doi:10.1177/1591019919864668

Cited by 5 publications

(7 citation statements)

References 23 publications

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“…Herein, we think recurrence caused by premature deflation is a major problem that needs to be considered. In addition, detachable balloons may eventually cause ICA occlusion and/or a cavernous sinus pseudoaneurysm, and these balloons have been less commonly used in the treatment of CCF ( 13 ). The detachable coil has good control ability, but there have been reports that mass stuffing in the cavernous sinus can cause compression of the cranial nerves and the possibility of aseptic inflammation, in addition to the high medical cost ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: emergent endovascular treatment for carotid cavernous fistulas presenting as intracranial hemorrhage

Chen

et al. 2023

Front. Neurol.

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ObjectivesThis study aimed to discuss the clinical characteristics and emergent endovascular treatment of carotid cavernous fistulas presenting as intracranial hemorrhage.MethodsThe clinical data of five patients with carotid cavernous fistulas, who presented with intracranial hemorrhage and who were admitted from January 2010 to April 2017, were analyzed retrospectively, and the diagnoses were confirmed by head computed tomography. Digital subtraction angiography was carried out in all the patients for the diagnosis and further emergent endovascular procedures. All patients were followed up to assess the clinical outcomes.ResultsIn total, five patients harbored five mono-lateral lesions; two of them were obliterated by detachable balloons, two by detachable coils, and one by detachable coils and Onyx glue. Only one patient was cured by another detachable balloon in the second session, and the other four patients were cured in the first session. At the 3- to 10-year follow-up, there was no intracranial re-hemorrhage in any of the patients; there was no recurrence of symptoms; and delayed occlusion of the parent artery was noted in one case.ConclusionEmergent endovascular therapy is indicated for carotid cavernous fistulas presenting as intracranial hemorrhage. Individualized treatment according to the characteristics of different lesions is safe and effective.

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Section: Discussionmentioning

confidence: 99%

Case report: emergent endovascular treatment for carotid cavernous fistulas presenting as intracranial hemorrhage

Chen

et al. 2023

Front. Neurol.

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“…3,5,8,9,12 The clinical presentation of CCF, however, depends on the angiographic type, in which highly pressurized blood is transmitted to the cavernous sinus from abnormal connections. 7 Direct CCF usually has a more dramatic and rapid clinical presentation. 3,12 Radiologic imaging, like plain CT scan and MRI, can be used to confirm the diagnosis of CCF.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with CCF can also experience diplopia, headache, and blurring of vision, caused by the increase in intra-cavernous pressure. 1 , 3 , 7 Other findings on physical examination include: corkscrewing of conjunctival vessels, extraocular movement limitation, color deficit, relative afferent pupillary defect, optic nerve anatomical changes, fundus changes, pulsatile bruit, and elevated intraocular pressure (IOP). 3 , 5 , 8 , 9 The clinical presentation of direct fistulas appears more acutely, compared to the indolent presentation of indirect fistulas.…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile and Management Outcomes among Patients with Carotid-Cavernous Fistula

2023

Acta Med Philipp

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Background. A carotid-cavernous sinus fistula (CCF) is an abnormal communication between the internal carotid artery and/or the external carotid artery and the cavernous sinus. There is a paucity of information on the ophthalmic outcomes of endovascular treatment for CCF in the Philippines.Objectives. This study aimed to describe the clinical experience of CCF in our institution in order to further our understanding of the disease. This study described the demographic profile, risk factors, and clinical features of patients with CCF, and compared the data of patients according to the type of CCF. The study discussed the changes in clinical features over time in CCF patients who chose not to undergo endovascular treatment. The study also discussed the clinical outcomes of CCF patients who underwent endovascular treatment and compared the clinical outcomes to CCF patients who did not undergo endovascular treatment. Methods.A retrospective cohort study design was performed using a medical record review of patients clinically diagnosed with CCF from January 2011 to June 2019.Results. One hundred twenty medical records of patients diagnosed with CCF were included. Based on angiographic findings, patients were grouped according to type of CCF, with 86 patients in Group 1 or Direct CCF, 23 patients in Group 2 or Indirect CCF, and 11 patients in Group 3 or Mixed type of CCF. The patients were also grouped according to treatment, with 109 patients in Group A, or patients who did not undergo endovascular treatment, and 11 patients in Group B, or patients who underwent endovascular treatment. There was a male predominance in CCF, most occurring in the age range of 26 to 35 years. Risk factors for CCF were trauma and hypertension. Clinical features included the presence of blurring of vision, proptosis, corkscrewing of conjunctival vessels, extraocular movement limitation, diplopia, audible bruit, elevated intraocular pressure, and pulsation. Findings on Computed Tomography scan included dilated superior ophthalmic vein, proptosis, and enlarged extraocular muscles. Direct CCF (Group 1) occurred mostly in males, with mean age of 39.1 years, and with trauma as the major risk factor. Indirect CCF (Group 2) occurred mostly in females, with mean age of 52.1 years, and with hypertension as the major risk factor. Regardless of the type of CCF, patients who did not undergo endovascular treatment can exhibit spontaneous improvement or worsening of clinical features. Patients who underwent endovascular treatment generally had favorable clinical outcomes, manifesting as either improvement or no worsening of features. There were minimal ophthalmic complications associated with treatment. Conclusion.Endovascular treatment is safe and effective in the improvement of visual acuity, corkscrewing of conjunctival vessels, amount of proptosis, extraocular movement limitation, diplopia, and presence of audible bruit.

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“…All selected studies were high-quality articles based on the criteria and cutoff of the Newcastle-Ottawa Scale. Consistent with other literature, 2,6 a study was evaluated as high quality if at least 60% of the criteria were met (total score of $5 of 8).…”

Section: Article Selection and Data Extractionmentioning

confidence: 97%

Considering Psychological and Cognitive Factors in Interventional Neuroradiology: A Systematic Literature Review

Riccietti,

Schiavolin,

Caldiera

et al. 2023

AJNR Am J Neuroradiol

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BACKGROUND: Interventional neuroradiology is a relatively recent discipline that diagnoses and treats cerebral vascular diseases. However, specific literature on cognitive and psychological domains of patients undergoing interventional neuroradiology procedures is limited. PURPOSE: Our aim was to review the existent literature on cognitive and psychological domains in patients undergoing interventional neuroradiology procedures to raise clinicians' awareness of their mental status.DATA SOURCES: Articles were searched in PubMed, EMBASE, and Scopus from 2000 to 2022 using terms such as "interventional neuroradiology," "psychology," and "cognition" according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.STUDY SELECTION: Of 1483 articles in English, 64 were included and analyzed. Twelve focused on psychological aspects; 52, on cognitive ones.DATA ANALYSIS: Regarding psychological aspects, it appears that early psychological consultations and "nonpharmacologic" strategies can impact the anxiety and depression of patients undergoing endovascular procedures. Regarding cognitive aspects, it appears that endovascular treatment is safe and generates similar or even fewer cognitive deficits compared with analogous surgical procedures.DATA SYNTHESIS: Among the 12 articles on psychological aspects, 6/12 were retrospective with one, while 6/12 were prospective. Among the 52 articles on cognitive aspects, 7/54 were retrospective, while 45/52 were prospective. LIMITATIONS:The main limitation derives from the inhomogeneity of the cognitive and psychological assessment tools used in the articles included in our analysis. CONCLUSIONS:Our review highlights the need to include cognitive and psychological assessments in clinical practice in case patients eligible for interventional neuroradiology procedures. In the future, much more research of and attention to cognitive and psychologic aspects of neurovascular disease is needed. Systematic incorporation of strategies and tools to access and address pre, peri-, and postprocedural psychological and cognitive components could have major benefits in patient satisfaction, recovery, and the success of endovascular practice.ABBREVIATIONS: CAS ¼ carotid artery stent placement; DAVF ¼ dural arteriovenous fistula; EC ¼ endovascular coiling; INR ¼ interventional neuroradiology; QoL ¼ quality of life; RCT ¼ randomized control trial; RIA ¼ ruptured intracranial aneurysm; SC ¼ surgical clipping; UIA ¼ unruptured intracranial aneurysm

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Internal carotid artery occlusion may affect long-term quality of life in patients with high-flow carotid cavernous fistulas

Cited by 5 publications

References 23 publications

Case report: emergent endovascular treatment for carotid cavernous fistulas presenting as intracranial hemorrhage

Case report: emergent endovascular treatment for carotid cavernous fistulas presenting as intracranial hemorrhage

Clinical Profile and Management Outcomes among Patients with Carotid-Cavernous Fistula

Considering Psychological and Cognitive Factors in Interventional Neuroradiology: A Systematic Literature Review

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