Transarterial treatment of direct carotico-cavernous fistulas with coils and Onyx

Ramalingaiah, Arvinda Hanumanthapura; Prasad, Chandrajit; Sabharwal, Paramveer; Saini, Jitender; Pandey, Paritosh

doi:10.1007/s00234-013-1224-z

Cited by 12 publications

(7 citation statements)

References 24 publications

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“…For indirect fistulas, with small and/or multiple fistulous points, we used Onyx-18, an ethylene-vinyl alcohol copolymer mixed with tantalum powder. We achieved a 62.5% success rate with Onyx-18, which is comparable to other reports [9,14,15,18,19], but inferior to coil embolisation, partly because we assumed those fistulas that we failed to microcatheterise and were bound to be treated with Onyx-18 were marked as failures in our calculations. Other authors used the technique successfully [15,18,19].…”

Section: Discussionsupporting

confidence: 85%

Superior ophthalmic vein and ophthalmic artery in immediate evaluation after endovascular treatment of carotid-cavernous fistulas

et al. 2019

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Purpose To validate superior ophthalmic vein (SOV) and ophthalmic artery (OA) usefulness in immediate evaluation of new endovascular approaches to treat carotid-cavernous fistulas (CCFs). Material and methods A retrospective review of 597 intracerebral malformation embolisations yielded 40 embolisations of CCF in the treatment of 18 patients. Two interventional radiologists performed detailed radiological angiographic assessments. Results Mean age at initial admission was 58.9 years (SD 18.5 years, range 24-85 years). Patients presented with: chemosis (50%), ocular bruit (50%), exophthalmos (61%), diminished visual acuity (77.8%), headache (16.7%), and intracerebral haemorrhage (5.55%), and 5.55% were asymptomatic. Unilateral fistulas (10-55.5%) showed more diversified venous drainage pattern than bilateral ones (8-44.4%). There were statistically significant differences in post-traumatic and spontaneous CCF regarding age (p = 0.036), type of fistula (p = 0.0008), and presence of pseudoaneurysm (p = 0.036). 77.8% of patients had increased ipsilateral SOV diameter. SOV enlargement was not associated with type of fistula, history of trauma, or degree of exophthalmos. Ipsilateral ophthalmic artery was visible in all patients on both pre- and postprocedural angiography on lateral projection. Pre- and post-procedural SOV diameter was significantly different. Internal carotid artery patency was 100%, while the overall final angiographic or clinical success was 85.7%. We had three cases of peri-procedural complications. Conclusions We reported changeable dynamics of SOV and OA after endovascular treatment of CCFs and proved the feasibility of coils and Onyx-18 in the treatment thereof.

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Section: Discussionsupporting

confidence: 85%

Superior ophthalmic vein and ophthalmic artery in immediate evaluation after endovascular treatment of carotid-cavernous fistulas

et al. 2019

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“…15) The usefulness of liquid embolizing substances, such as Etylene vinyl oxide copolymer (Onyx) (eV3 Covidien, Irvine, CA, USA) and N-butyl-2-cyanoacrylate (NBCA), has been reported, but glue migration-related complications may occur. 16) In some cases in which sinus packing is required, an access to the SOV or cortical outflow tract becomes difficult in the latter half of the procedure regardless of the type of embolizing substance; embolization of the venous outflow tract should be predominantly conducted. In the present case, embolization of the cortical venous outflow tract was single coil through a transvenous approach.…”

Section: Resultsmentioning

confidence: 99%

Transvenous Target Embolization for a Small Sized, Non-traumatic Direct Carotid-cavernous Fistula using a Single Coil: Technical Case Report

Hayashi

Okada

Tomura

et al. 2016

JNET

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Purpose:We report on a patient who underwent transvenous target embolization of a small, direct carotid-cavernous fistula (CCF). Case:A 74-year-old female without a history of trauma was referred to our department. Tinnitus and ocular symptoms initially occurred as symptoms of a right, direct CCF. Anterograde blood flow at the peripheries of the anterior and middle cerebral arteries was maintained, and an Allcock test confirmed a fistula connecting from the C3 region of the internal carotid artery to the cavernous sinus. Transvenous target embolization of the fistula was performed while protecting the internal carotid artery using a balloon. The use of only a single coil led to the disappearance of the shunt. Conclusion:In some patients, a small, direct CCF can be cured by target embolization. It is important to predict the size of a fistula and clearly visualize the fistulous site in the process of diagnosis.

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“…High success rates with endovascular embolization of CC fistulas are reported across the board. [45][46][47][48] Liu et al reported recovery of oculomotor function after initial treatment with detachable balloons in all of 98 patients who presented with oculomotor nerve paresis in the setting of a traumatic CC fistula. 49 Visual impairment also often recovers within the first 2 weeks after endovascular therapy if the fistula is treated early.…”

Section: Carotid Cavernous Fistulasmentioning

confidence: 99%

“…49 Visual impairment also often recovers within the first 2 weeks after endovascular therapy if the fistula is treated early. 46…”

Section: Carotid Cavernous Fistulasmentioning

confidence: 99%

Surgical and Nonsurgical Treatment of Vascular Skull Base Trauma

Dahlin

Waldau

2016

J Neurol Surg B

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Transarterial treatment of direct carotico-cavernous fistulas with coils and Onyx

Cited by 12 publications

References 24 publications

Superior ophthalmic vein and ophthalmic artery in immediate evaluation after endovascular treatment of carotid-cavernous fistulas

Superior ophthalmic vein and ophthalmic artery in immediate evaluation after endovascular treatment of carotid-cavernous fistulas

Transvenous Target Embolization for a Small Sized, Non-traumatic Direct Carotid-cavernous Fistula using a Single Coil: Technical Case Report

Surgical and Nonsurgical Treatment of Vascular Skull Base Trauma

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