Electrothrombosis of carotid-cavernous fistula.
The author describes a technique for directly closing a carotid cavernous fistula with electrothrombosis while preserving the intracranial arterial circulation. Copper wires are introduced through the superior ophthalmic vein or a frontotemporal craniotomy, and thus directly into the portion of the sinus into which the fistula drains; if posterior, into the posterior segment of Parkinson's triangle, if inferior, into the pterygoid plexus, and if anterior, through the sphenoparietal sinus and/or middle cerebral vein to the anterior-inferior portion of the sinus. A direct current is applied until a thrombus is confirmed angiographically and the wires are left in place. Four patients treated by this method are presented.
D000293:Adolescent; D000328:Adult; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal; D002404:Catheterization; D002426:Cavernous Sinus; D002533:Cerebral Angiography; D004598:Electrosurgery / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged