2,660 results match your criteria Carotid-Cavernous Fistula

Endovascular Treatment of Cavernous Sinus Dural Arteriovenous Fistula via Radial Artery and Median Cubital Vein.

Neurointervention 2021 Jun 10. Epub 2021 Jun 10.

Department of Radiology, Sarawak General Hospital, Kuching, Malaysia.

Cavernous sinus dural arteriovenous fistula (CS-DAVF) is an arteriovenous shunt where there is fistulous blood flow from the dural arteries from the internal or external carotid artery into the cavernous sinus. The current mainstay of therapy is endovascular treatment. We present a case of restrictive type of CS-DAVF in a 75-year-old male who presented with right eye symptoms. Read More

View Article and Full-Text PDF

Ocular ischaemic syndrome following coil embolisation for direct carotid cavernous fistula.

BMJ Case Rep 2021 May 27;14(5). Epub 2021 May 27.

Child Sight Institute, Jasti V Ramanamma Children's Eye Care Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India.

A 36-year-old man presented with proptosis and external ophthalmoplegia of the left globe following road traffic injury. Cerebral angiogram revealed moderate flow direct carotid cavernous fistula on left side for which coil embolisation was done repeatedly. Subsequently, the patient developed decreased vision in left eye and developed features of left-sided ocular ischaemic syndrome. Read More

View Article and Full-Text PDF

Transvenous embolization of a direct carotid-cavernous fistula through the pterygoid plexus approach.

Radiol Case Rep 2021 Jul 7;16(7):1806-1809. Epub 2021 May 7.

Department of Neuroradiology, E-Da Hospital, I-Shou University, No. 1, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung, Taiwan.

We present a transvenous embolization technique for a direct carotid-cavernous fistula through the pterygoid plexus to the cavernous sinus which only 2 cases have been previously reported in the English literature. This method is appropriate when transarterial techniques or other attempts at transvenous access have failed due to vessel tortuosity, hypoplasia, stenosis, or occlusion. A middle-aged female patient presented with progressive left exophthalmos with conjunctiva chemosis and bruit after sustaining a falling injury. Read More

View Article and Full-Text PDF

Target Coil Embolization Using the Combined Transarterial and Transvenous Balloon-assisted Technique for Traumatic Direct Carotid Cavernous Fistula.

NMC Case Rep J 2021 Apr 2;8(1):13-19. Epub 2021 Apr 2.

Department of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan.

Herein, we describe a case of traumatic direct carotid cavernous fistula (DCCF) treated with target coil embolization using the combined transarterial and transvenous balloon-assisted technique. The patient was a 59-year-old woman who had been involved in a vehicular accident. She was admitted to the hospital due to chemosis and exophthalmos. Read More

View Article and Full-Text PDF

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

Interv Neuroradiol 2021 May 10:15910199211014701. Epub 2021 May 10.

Department of Neurosurgery, 401 General Military Hospital of Athens, Athens, Greece.

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. Read More

View Article and Full-Text PDF

Carotid-Cavernous Sinus Fistula Masquerading as Thyroid Eye Disease.

Cureus 2021 Apr 2;13(4):e14261. Epub 2021 Apr 2.

Department of Ophthalmology, Division of Oculofacial Plastic & Orbital Surgery, Gavin Herbert Eye Institute, University of California, Irvine, Irvine, USA.

A 29-year-old man with a medical and social history notable for smoking presented with progressive orbital congestion, conjunctival injection, and extraocular muscle enlargement consistent with thyroid eye disease (TED). On ophthalmologic examination, tortuous episcleral vessels and blood in Schlemm's canal on gonioscopy clued an alternative diagnosis. Cavernous sinus enhancement on computed tomography also suggested a retro-orbital process. Read More

View Article and Full-Text PDF

Successful repair of spontaneous indirect bilateral carotid-cavernous fistula with coil embolization.

J Surg Case Rep 2021 Apr 22;2021(4):rjab140. Epub 2021 Apr 22.

Department of Ophthalmology, Loma Linda University School of Medicine, Loma Linda, CA, USA.

Bilateral carotid-cavernous fistula (CCF) is a rare disease process, which portends poor visual outcome with delayed diagnosis and treatment. An 82-year-old woman presented with sudden onset of proptosis and decreased vision. A complete ophthalmologic examination along with magnetic resonance (MR) imaging of the brain and orbits, and MR angiography and venography of the brain confirmed the diagnosis of bilateral CCF. Read More

View Article and Full-Text PDF

Acute Onset Variable and Progressive Trochlear Nerve Palsy and Ophthalmoparesis Secondary to Bilateral Carotid Cavernous Fistula.

J Binocul Vis Ocul Motil 2021 Apr-Jun;71(2):50-54. Epub 2021 Apr 15.

Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.

: To describe a patient who presented with right unilateral white-eyed posteriorly-draining carotid-cavernous fistulas (CCF) causing an isolated, acute-onset trochlear nerve palsy with atypical progression to a contralateral left red-eyed anteriorly-draining CCF associated with orbital congestion.: A 74-year-old female presented with an acute onset incomitant right hypertropia consistent with the clinical diagnosis of a superior oblique palsy. Initial workup including MRI was normal. Read More

View Article and Full-Text PDF

A rare complication of an Arteriovenous shunt after bimaxillary surgery.

JPRAS Open 2021 Jun 11;28:90-96. Epub 2021 Mar 11.

Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Netherlands.

The most common complications following bimaxillary surgery are inferior alveolar nerve damage, hemorrhage, and relapse. Severe complications are rare, but few cases of vascular arteriovenous malformation, cavernous sinus thrombosis, formation of an aneurysm or arteriovenous shunting are reported in literature. We present a case of a 20-year-old male patient who developed a right sided tinnitus and visible pulsations close to the mandibular angle on the right side after bimaxillary surgery. Read More

View Article and Full-Text PDF

Targeted Transvenous Embolization of Cavernous Sinus Dural Arteriovenous Fistula With Liquid Materials Using a Dual-Lumen Balloon Microcatheter.

Cureus 2021 Mar 11;13(3):e13821. Epub 2021 Mar 11.

Neurosurgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, JPN.

We describe a challenging transvenous embolization technique involving a dual-lumen balloon microcatheter (DLBM) and liquid materials for cavernous sinus dural arteriovenous fistula (CSDAVF). DLBM contributed to identifying the shunt point and preventing liquid material leakage to normal venous drainage without treatment-related complications. In a transvenous embolization using liquid materials for CSDAVF complications such as cranial nerve palsy and embolic agent migration into the internal carotid artery due to numerous anastomoses must be considered. Read More

View Article and Full-Text PDF

Salvage transorbital approach for the endovascular treatment of carotid cavernous fistulas.

Oral Maxillofac Surg 2021 Apr 5. Epub 2021 Apr 5.

Unit of Interventional Neuroradiology, Careggi Hospital, Largo Piero Palagi 1, 50139, Florence, Italy.

Purpose: Carotid cavernous fistulas (CCFs) are abnormal connections between the cavernous sinus (CS) and carotid arteries. In direct CCFs, a transarterial route is often the preferred vascular access; in case of indirect CCFs, the complex anatomy of the feeder vessels and their extra-intracranial anastomosis makes the transarterial embolization challenging and often ineffective. The aim of this study was to review our experience with the transorbital approach to treat patients affected by CCF who have already experienced an endovascular failure procedure, in order to assess this salvage technique feasibility, by analyzing possible risks and complications. Read More

View Article and Full-Text PDF

A technique to facilitate the cannulation of the foramen ovale for balloon compression.

Br J Neurosurg 2021 Mar 30:1-4. Epub 2021 Mar 30.

Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Background: Percutaneous balloon compression is a safe and effective treatment for trigeminal neuralgia. Current technique consists of penetrating the foramen ovale using a sharp 14G needle with a stylet. Difficulty of cannulation of the foramen ovale, failures of cannulation and major neurovascular complications of the procedure, although rare, may be due to the relatively large caliber of this needle and its sharp tip. Read More

View Article and Full-Text PDF

Treatment of post-traumatic direct carotid-cavernous fistulas using flow diverting stents: Is it alone satisfactory?

J Clin Neurosci 2021 Apr 11;86:230-234. Epub 2021 Feb 11.

Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Direct carotid cavernous fistula (CCF) occurs between the internal carotid artery (ICA) and the cavernous sinus. Carotid cavernous fistulas (CCFs) frequently present with chemosis, pulsatile proptosis, ocular bruit, vision loss, and occasionally intracerebral hemorrhage or seizure. In this article, we share our experience in endovascular treatment of six patients having this pathology with intracranial flow diverting stents with review of literatures. Read More

View Article and Full-Text PDF

Carotid cavernous fistula (CCF) treatment approaches: A systematic literature review and meta-analysis of transarterial and transvenous embolization for direct and indirect CCFs.

Clin Neurol Neurosurg 2021 May 20;204:106601. Epub 2021 Mar 20.

Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA.

Background: Carotid Cavernous Fistulas (CCFs) are the result of an abnormal communication between the carotid artery and its branches and the venous system of the cavernous sinus. The mainstay of therapy for CCFs consists of transarterial or transvenous embolization, while other treatment options such as open surgery or radiosurgery are still utilized as second-line or adjuvant therapeutic options.

Objective: Our aim was to systematically review and summarize available data regarding short- and long-term outcomes of all available treatment modalities for CCFs. Read More

View Article and Full-Text PDF

Concurrent carotid-cavernous fistula and cervical internal carotid artery pseudoaneurysm due to a gunshot injury: A case report.

Neurochirurgie 2021 Mar 23. Epub 2021 Mar 23.

Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Rosario University School of Medicine, Bogotá, Colombia; Department of Neurosurgery, Central Military Hospital, Nueva Granada Military University, Bogotá, Colombia.

View Article and Full-Text PDF

Four-dimensional digital subtraction angiography for exploration of intraosseous arteriovenous fistula in the sphenoid bone.

Surg Neurol Int 2021 2;12:85. Epub 2021 Mar 2.

Department of Neurosurgery, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan.

Background: Intraosseous arteriovenous fistula (AVF) is a rare clinical entity that typically presents with symptoms from their effect on surrounding structures. Here, we report a case of intraosseous AVF in the sphenoid bone that presented with bilateral abducens palsy.

Case Description: A previously healthy man presented with tinnitus for 1 month, and initial imaging suspected dural AVF of the cavernous sinus. Read More

View Article and Full-Text PDF

Carotid-cavernous sinus fistula following mechanical thrombectomy in acute ischaemic stroke: a rare complication.

Neuroradiology 2021 Mar 23. Epub 2021 Mar 23.

Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse 25, CH-5001, Aarau, Switzerland.

Carotid-cavernous sinus fistulas (CCFs) are abnormal communications between the internal carotid artery (ICA) and the cavernous sinus (CS). Direct CCFs are associated with trauma or are iatrogenic complications of neuroendovascular procedures. Meanwhile, mechanical endovascular thrombectomy (MT) in acute ischaemic stroke (AIS) patients with large vessel occlusion (LVO) has been established as a common treatment approach. Read More

View Article and Full-Text PDF

Treatment of a rare and complex carotid-cavernous fistula.

BMJ Case Rep 2021 Mar 22;14(3). Epub 2021 Mar 22.

Department of Neurological Surgery, University Hospitals, Cleveland, Ohio, USA.

Carotid-cavernous fistulas (CCFs) are abnormal connections between arteries and the cavernous sinuses. Traditionally, the Barrow Classification system has been used to characterise these fistulas based on their arterial supply from the internal carotid artery (ICA), external carotid artery (ECA) or both. We present a unique case of a patient with a complex CCF with arterial feeders from dural branches of the ECA, ICA and vertebral artery (VA), which, to our knowledge, has not been reported in the literature. Read More

View Article and Full-Text PDF

Is the retrograde access for endovascular treatment of a traumatic carotid cavernous fistula associated with dissection of the ipsilateral carotid possible?

J Cerebrovasc Endovasc Neurosurg 2021 Mar 17;23(1):54-59. Epub 2021 Mar 17.

Department of Interventional Neuroradiology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

This is a case demonstrating a combined traumatic lesion of the internal carotid artery (dissection and a carotid cavernous fistula [CCF]) in a patient who was beaten during a robbery and, while trying to escape, was hit by a vehicle. Endovascular approach for the treatment was chosen using the retrograde access from the vertebral artery to the cavernous sinus by posterior communicating (Pcom) artery due to the occlusion of the ipsilateral internal carotid. Because the artery access by the internal carotid was impossible, retrograde approach by vertebral artery and Pcom artery was done to treat the direct CCF. Read More

View Article and Full-Text PDF

Carotid cavernous fistula presenting as common red eye.

CJEM 2021 Jan 10;23(1):123-125. Epub 2020 Dec 10.

Section of Ophthalmology, Department of Surgery, University of Calgary, 7007 14th 7 St SW, Calgary, AB, T2V 1P9, Canada.

View Article and Full-Text PDF
January 2021

Observation of fundus and optical coherence tomography angiography manifestations in carotid cavernous fistula patients.

Graefes Arch Clin Exp Ophthalmol 2021 Mar 3. Epub 2021 Mar 3.

Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 1# Shuaifuyuan, Dongdan, Beijing, 100730, China.

Purpose: This study aimed to investigate fundus and optical coherence tomography angiography (angio-OCT) manifestations in carotid cavernous fistula (CCF) patients.

Methods: Nine eyes of 7 CCF patients diagnosed with digital subtraction angiography (DSA) were included in this study. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp, fundus, spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (angio-OCT) examination in the CCF patients and 10 normal controls were conducted. Read More

View Article and Full-Text PDF

Endovascular treatment of extracranial carotid artery aneurysms using self-expandable covered stent grafts: A single center retrospective study.

Vascular 2021 Feb 17:1708538121990120. Epub 2021 Feb 17.

Department of Vascular Surgery, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Ji'nan, China.

Objectives: This study was aimed to evaluate the safety and efficacy of endovascular treatment of extracranial carotid artery aneurysms (ECAAs) using self-expandable covered stent grafts.

Methods: All patients with ECAA at a single institution were reviewed from February 2014 to February 2020. Eight consecutive patients (three men, mean age 64. Read More

View Article and Full-Text PDF
February 2021

Post-traumatic carotid-cavernous fistula.

Pract Neurol 2021 Jun 15;21(3):259-260. Epub 2021 Feb 15.

Neurosurgery, Hospital Universitario Marques de Valdecilla, Santander, Spain.

View Article and Full-Text PDF

Carotid Cavernous Fistula Treatment via Flow Diversion: A Systematic Review of the Literature.

World Neurosurg 2021 May 9;149:e369-e377. Epub 2021 Feb 9.

Department of Neurosurgery, University of Arizona, Tucson, Arizona, USA. Electronic address:

Background: Carotid cavernous fistulas (CCFs) are pathologic connections between the carotid arteries and the cavernous sinus and have been classically treated with endovascular coil embolization, although flow diverters have been used for treatment successfully multiple times. The aim of this study is to systematically review the literature for efficacy of flow diverters in treating CCFs.

Methods: A systematic review was conducted using the PRISMA guidelines. Read More

View Article and Full-Text PDF

Perisylvian Arteriovenous Malformation Mimicking Carotid Cavernous Fistula: Operative Video.

Cureus 2020 Dec 26;12(12):e12297. Epub 2020 Dec 26.

Neurological Surgery, Advocate Christ Medical Center, Oak Lawn, USA.

Brain arteriovenous malformations (AVM) commonly present for medical attention after a patient experiences a rupture that results in a focal neurologic deficit, an epileptic event, or is found incidentally on cranial imaging performed for an unrelated reason. In contrast, carotid-cavernous fistulas (CCF) can develop high-flow arteriovenous shunting with symptoms attributable to venous hypertension. We discuss a unique case of a 54-year-old female presenting with signs and symptoms suggestive of a CCF but was found to have a perisylvian AVM with an enlarged draining vein draining into the cavernous sinus. Read More

View Article and Full-Text PDF
December 2020

Blood in Schlemm's Canal from a Carotid-Cavernous Fistula.

Ophthalmol Glaucoma 2021 Jan-Feb;4(1):112

Gavin Herbert Eye Institute, University of California Irvine, Irvine, California.

View Article and Full-Text PDF

Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula.

Case Rep Anesthesiol 2021 5;2021:2342347. Epub 2021 Jan 5.

Penn State Milton S. Hershey Medical Center, Department of Anesthesiology & Perioperative Medicine, Hershey, PA, USA.

Carotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery or its branches into the cavernous sinus. Endovascular embolization is the treatment modality of choice. The trigeminocardiac reflex (TCR) is a vagally mediated reflex that can lead to hemodynamic instability. Read More

View Article and Full-Text PDF
January 2021

Man With Double Vision.

Ann Emerg Med 2021 02;77(2):179-220

Department of Emergency Medicine, Cook County Health, Chicago, IL.

View Article and Full-Text PDF
February 2021

[Clinical and sonographic examination findings in patients with carotid-cavernous sinus fistulas].

Ophthalmologe 2021 Jan 18. Epub 2021 Jan 18.

Universitätsaugenklinik Erlangen, FAU Erlangen-Nürnberg, Erlangen, Deutschland.

Background: Symptoms and clinical findings in patients with carotid-cavernous fistulas are specific. Nevertheless, they can be very mildly expressed. This study aims to point out the potential diagnostic value of ultrasound of the orbit. Read More

View Article and Full-Text PDF
January 2021

Acute Orbital Compartment Syndrome After Coil Embolization of a Contralateral Carotid Cavernous Fistula.

J Neuroophthalmol 2021 Jan 11. Epub 2021 Jan 11.

Department of Ophthalmology (CLG, AAT, AQT, CO, KJG), Weill Cornell Medical College, New York, New York; Weill Cornell Medical College (AYJL), New York, New York; and Departments of Neurological Surgery (AP) and Radiology (AP), Weill Cornell Medical College, New York, New York.

View Article and Full-Text PDF
January 2021