[Transvenous embolization in treatment of refractory carotid-cavernous sinus fistula].
OBJECTIVE
To investigate the effects of transvenous embolization in treatment of refractory carotid-cavernous sinus fistula (CCF).


METHODS
Twenty-five patients of refractory CCF with 28 foci underwent transvenous embolization, femoral vein-inferior petrosal sinus approach was used in 12 of which, and femoral vein-facial vein-superior ophthalmic vein approach was used in 12 of which. The embolizing materials included controllable coils (GDC, EDC), free coil, and silk. Three to twenty-four months after the treatment angiography was conducted on 10 patients and telephone follow-up was conducted on the other 15 patients.


RESULTS
Immediate complete angiographic obliteration of the fistula was achieved in 20 patients. Residual shunting was left in 5 patients, 2 with pterygoid drainage and 3 with inferior petrosal sinus drainage. Headache and vomiting were the common symptoms after embolization. The angiography during follow-up showed that there were residual shunting in 4 patients, residual inferior petrosal drainage in 1 patient, and residual pterygoid drainage in 1 patient, and that no reoccurrence was found in the 6 patients with complete angiographic obliteration. The patients undergoing telephone follow-up reported that they had not any symptom.


CONCLUSIONS
Safe and effective, transvenous embolization can be the first choice after the failure in treatment of the carotid-cavernous sinus fistula.
Liu
Ai-hua
AH
Beijing Neurosurgical Institute, Beijing 100050, China.
Wu
Zhong-xue
ZX
Jiang
Chu-han
CH
Li
You-xiang
YX
Zhang
You-ping
YP
Yang
Xin-jian
XJ
Zhang
Jing-bo
JB
Jiang
Peng
P
Lü
Ming
M
Wang
Zhong-cheng
ZC
D000293:Adolescent; D000328:Adult; D000368:Aged; D020216:Carotid-Cavernous Sinus Fistula / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005123:Eye / Q000098:blood supply; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014680:Veins; D014839:Vomiting / Q000209:etiology