Combined transarterial, transvenous, and direct puncture of the cavernous sinus to cure a traumatic carotid cavernous fistula

Chung Jung Lin*, Chao Bao Luo, Feng Chi Chang, Michael Mu Huo Teng, Kao Lun Wang, Shu Hsun Chu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Direct carotid cavernous fistulas (CCF) are generally well managed by simple endovascular treatment. We report an 8-year-old boy who required subsequent direct puncture of the cavernous sinus to completely obliterate the residual fistula after both transarterial and transvenous embolization had been performed. He presented with a mild right frontal headache, congestion of the right conjunctiva, blurred vision, and photophobia. Cerebral angiography demonstrated a right direct CCF. The patient underwent transarterial and transvenous embolization of the cavernous sinus (CS) with Gugliemi detached coils (GDCs), but a residual shunt persisted. Two days later, another session of embolization by direct puncture of the CS with GDCs was performed after failure to navigate through the superior ophthalmic vein which was partially occupied by previously deployed coils. Immediate control angiography showed complete obliteration of the fistula and the patient's symptoms rapidly resolved. This is the first report of a patient with a CCF who required three combined approaches - transarterial, transvenous, and direct puncture of the CS - to achieve complete closure of the complexed shunt.

Original languageEnglish
Pages (from-to)1663-1665
Number of pages3
JournalJournal of Clinical Neuroscience
Volume16
Issue number12
DOIs
StatePublished - Dec 2009

Keywords

  • Carotid cavernous fistula
  • Transarterial embolization
  • Transorbital
  • Transvenous embolization

Fingerprint

Dive into the research topics of 'Combined transarterial, transvenous, and direct puncture of the cavernous sinus to cure a traumatic carotid cavernous fistula'. Together they form a unique fingerprint.

Cite this