Carotid cavernous fistula: embolization via a bilateral superior ophthalmic vein approach.
We report the case of a 74-year-old woman with a complex indirect (Barrow D) carotid cavernous sinus fistula. The patient was treated incrementally and finally cured by a rarely reported bilateral retrograde direct transvenous approach via the superior ophthalmic vein. The treatment of the complex carotid cavernous fistula with multiple bilateral fistula points showed additional complexity due to a partially thrombosed left superior ophthalmic vein, which required a combined microsurgical and endovascular treatment, showing that treatment can be achieved, if necessary, by catheterization of a thrombosed orbital vein.
Berlis
Ansgar
A
Department of Neuroradiology, University of Freiburg, Freiburg, Germany.
Klisch
Joachim
J
Spetzger
Uwe
U
Faist
Michael
M
Schumacher
Martin
M
D000368:Aged; D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications / Q000628:therapy*; D004621:Embolization, Therapeutic; D005123:Eye / Q000098:blood supply*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010690:Phlebography; D013479:Superior Vena Cava Syndrome / Q000150:complications / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures; D014680:Veins / Q000601:surgery