Verifying complete obliteration of carotid artery-cavernous sinus fistula: Role of color Doppler ultrasonography

Hong Jen Chiou, Yi Hong Chou*, Wan Yuo Guo, Michael Mu Huo Teng, Chung Chuan Hsu, Chui Mei Tiu, Jiing Feng Lirng, Chao Bao Luo, Cheng Ying Shiau, David Hung Chi Pan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

The purpose of this study was to evaluate the role of color Doppler ultrasonography in verifying obliteration of carotid artery-cavernous sinus fistula before and after therapeutic embolization or gamma knife radiosurgery. Before treatment, carotid artery-cavernous sinus fistula showed the following data on color Doppler ultrasonography: (1) increased blood flow in the common carotid artery (220 to 1264 ml/min with mean ± SD of 728 ± 378 ml/min); internal carotid artery (435 to 1097 ml/min with mean ± SD of 834 ± 216 ml/min) in fistulas of the direct type; and external carotid artery (85 to 257 ml/min with mean ± SD of 170 ± 75 ml/min) in fistulas of the indirect type in comparison to the contralateral side; (2) reverse pulsatile flow or spiculated wave form with turbulent flow in the engorged superior ophthalmic vein on the lesion side in all patients. All of the above abnormal hemodynamic changes became normal in six patients immediately after first embolization, in two patients with balloon embolization combined with subsequent direct embolization by direct puncture through the superior orbital fissure or internal carotid artery embolization, and in five patients after gamma knife radiosurgery at 4, 4, 8, 9, and 9 months, respectively. Color Doppler ultrasonography might be a good modality in long-term follow- up of carotid artery-cavernous sinus fistula after gamma knife radiosurgery and embolization.

Original languageEnglish
Pages (from-to)289-295
Number of pages7
JournalJournal of Ultrasound in Medicine
Volume17
Issue number5
DOIs
StatePublished - May 1998

Keywords

  • Carotid artery-cavernous sinus fistula
  • Color Doppler ultrasonography
  • Eye
  • Superior ophthalmic vein

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