Endovascular treatment of carotid-cavernous fistulae.
BACKGROUND
In the embolotherapy for the treatment of carotid-cavernous fistulae (CCF) several embolic agents and techniques have been reported. In this series the efficiency of transarterial electrothrombosis with Guglielmi detachable coils (GDC) in direct fistulae and the occlusion with particles, tissue glue and platinum coils in indirect fistulae is studied and the implications of these findings is discussed regarding classification, conservative therapy and follow-up.


METHODS
Eleven consecutive patients were reviewed retrospectively. Four patients had direct high flow fistulae from the internal carotid arteries and the rest had low flow dural fistulae. Postprocedural clinical outcome and angiographical follow-up are presented.


RESULTS
Six patients became symptom free, in 4 patients the symptoms resolved and 1 patient suffered a minor procedural complication. In the 8 follow-up angiographies the fistulae of 7 patients were totally closed, including the 4 patients with direct fistulae.


CONCLUSIONS
Progressive clinical manifestations require embolization to alleviate the symptoms and to prevent further complications of the arteriovenous shunting. Embolization with GDC is a feasible, effective and safe method in direct fistulae.
Kähärä Veikko
J
J
Department of Radiology, Tampere University Hospital, Finland.
Seppänen
S
S
Kuurne
T
T
Laasonen
E M
EM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000628:therapy*; D002342:Carotid Artery, External / Q000002:abnormalities*; D002343:Carotid Artery, Internal / Q000002:abnormalities*; D002426:Cavernous Sinus / Q000002:abnormalities*; D002533:Cerebral Angiography; D004598:Electrosurgery / Q000009:adverse effects / Q000379:methods*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005094:Exophthalmos / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D012189:Retrospective Studies; D016896:Treatment Outcome