title: Transvenous embolization of high flow carotid cavernous fistula: a case report.
abstract: We treated a patient with a high flow traumatic carotid-cavernous fistula (CCF) by embolization using detachable balloons and metallic coils, by transarterial and transvenous approaches. The patient was a 20-year-old woman who had fractures in the skull base from a traffic accident. She was admitted to our hospital one month after the accident due to exophthalmos, chemosis, and periorbital bruit. Cerebral angiograms demonstrated left traumatic CCF and steal phenomenon of blood flow. Balloon embolization by transarterial approach performed three times was unsuccessful, probably because of balloon puncture due to bone fragments. Embolization using metalic coils via the superior ophthalmic vein route was then attempted. As a result of this approach, complete obliteration of CCF was obtained, and clinical symptoms subsided within a few days. Treatment of CCF by transvenous approach is one alternative when transarterial occlusion is difficult.
authors.affiliation: Department of Radiology, Kagawa Medical School, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ohkawa
authors.forename: N
authors.initials: N
authors.lastname: Fujiwara
authors.forename: I
authors.initials: I
authors.lastname: Hino
authors.forename: K
authors.initials: K
authors.lastname: Satoh
authors.forename: H
authors.initials: H
authors.lastname: Takashima
authors.forename: M
authors.initials: M
authors.lastname: Tanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Honjo
authors.forename: K
authors.initials: K
authors.lastname: Irie
authors.forename: S
authors.initials: S
authors.lastname: Nagao
authors.forename: K
authors.initials: K
authors.lastname: Kojima
authors.forename: K
authors.initials: K
authors.lastname: Osaka
mesh_terms: D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002426:Cavernous Sinus / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D012887:Skull Fractures / Q000150:complications