title: [Transvenous embolization in treatment of refractory carotid-cavernous sinus fistula].
abstract: 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.
authors.affiliation: Beijing Neurosurgical Institute, Beijing 100050, China.
authors.forename: Ai-hua
authors.initials: AH
authors.lastname: Liu
authors.forename: Zhong-xue
authors.initials: ZX
authors.lastname: Wu
authors.forename: Chu-han
authors.initials: CH
authors.lastname: Jiang
authors.forename: You-xiang
authors.initials: YX
authors.lastname: Li
authors.forename: You-ping
authors.initials: YP
authors.lastname: Zhang
authors.forename: Xin-jian
authors.initials: XJ
authors.lastname: Yang
authors.forename: Jing-bo
authors.initials: JB
authors.lastname: Zhang
authors.forename: Peng
authors.initials: P
authors.lastname: Jiang
authors.forename: Ming
authors.initials: M
authors.lastname: Lü
authors.forename: Zhong-cheng
authors.initials: ZC
authors.lastname: Wang
mesh_terms: 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