[Treatment of carotid-cavernous fistulas].
OBJECTIVE
To evaluate the results of the treatment of 33 patients with carotid-cavernous fistula (CCF) with respect to clinical and angiographic criteria.


METHODS
From January 1993 to December 2003, 33 patients were diagnosed with CCF and treated at our hospital. All patients underwent clinical examination and angiography before and after treatment. Available treatment modalities were conservative treatment, consisting of compressions, and interventional treatment, with different procedures depending on the approach and the materials employed for embolization.


RESULTS
Of the 11 direct CCFs, one received conservative treatment and 10 underwent embolization procedures. An arterial approach was used in 5 cases, a venous approach in 2, and a combined venous-arterial approach in the remaining 3, with symptoms disappearing in 90% of the patients. Of the 22 indirect or dural CCFs, 6 received conservative treatment, with optimal results, and the remaining 16 underwent embolization (11 using an arterial approach and 5 using a combined venous-arterial approach). Endovascular treatment brought about the complete disappearance of symptoms in 9 patients and partial disappearance in 7. Only one transitory complication was observed.


CONCLUSIONS
The appropriate selection of both the type of treatment (conservative vs. interventional) and the interventional procedure (approach and material for embolization), yields optimal results in the management of patients with CCF.
Crespo Rodríguez
A Ma
AM
Sección de Neurorradiología, Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España.
Angulo Hervías
E
E
Franco Uliaque
C
C
Guillén Subirán
Ma E
ME
Barrena Caballo
Ma R
MR
Guelbenzu Morte
S
S
D000328:Adult; D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D002339:Carotid Arteries / Q000002:abnormalities* / Q000000981:diagnostic imaging; D002426:Cavernous Sinus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome