title: [Refractory carotid-cavernous fistula: causes and countermeasures].
abstract: OBJECTIVE
  To explore the causes and countermeasures of refractory carotid-cavernous fistula (CCF).
  
  
  METHODS
  Twelve refractory cases from 123 cases of consecutive traumatic CCF during 12 years were reviewed.
  
  
  RESULTS
  The main causes of refractory CCF were: small or large fistula's opening, or constrictive parent artery; inappropriate early treatments such as ligature of internal carotid artery or common carotid artery, balloon detachment of, and non-dense packing of coils inside the cavernous sinus; unexpected deflation or balloon displacement of resulting in fistula recurrence. Anatomical cure was achieved in 11 cases, and clinical care in 1 by using balloon or/and coil or/and NBCA (n-butal 2-cyanoacrylate) through arterial, venous or surgical approach.
  
  
  CONCLUSIONS
  refractory CCF can be treated effectively skilled catheterization and embolization as well as appropriate approach and embolic material according to fistula structure and vascular route.
authors.affiliation: Research Center of Interventional Neuroradiology, Beijing Hospital, Beijing 100730.
authors.forename: D
authors.initials: D
authors.lastname: Wang
authors.forename: F
authors.initials: F
authors.lastname: Ling
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: Z
authors.initials: Z
authors.lastname: Miu
authors.forename: Q
authors.initials: Q
authors.lastname: Song
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.forename: M
authors.initials: M
authors.lastname: Hao
mesh_terms: D000293:Adolescent; D000328:Adult; D021721:Balloon Occlusion; D020216:Carotid-Cavernous Sinus Fistula / Q000473:pathology / Q000628:therapy*; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D004659:Enbucrilate