Usefulness of intravascular ultrasonography monitoring of coil embolization for traumatic direct carotid-cavernous fistula-case report-.
A 61-year-old woman was admitted for head injury after a traffic accident. Two months later, she developed abducens nerve palsy, chemosis, and pulsatile tinnitus. Right internal carotid angiography demonstrated a high flow direct carotid-cavernous fistula (CCF) at the C(5) portion with reflux into the superficial and deep sylvian veins, superior ophthalmic vein, superior petrosal sinus, and inferior petrosal sinus. Intravascular ultrasonography (IVUS) revealed a large fistula at the C(5) portion of the internal carotid artery (ICA). Coil embolization via transarterial and transvenous approaches under IVUS monitoring was performed. During the procedure, IVUS accurately detected protrusion of a coil into the parent ICA, and the parent artery could be preserved. IVUS monitoring is useful for embolization of direct CCF with coils.
Nishio
Akimasa
A
Department of Neurosurgery, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan. m3275727@med.osaka-cu.ac.jp
Kawakami
Taichiro
T
Mitsuhashi
Yutaka
Y
Hayasaki
Koji
K
Kiyama
Miki
M
Tada
Yuichi
Y
Ohata
Kenji
K
D020434:Abducens Nerve Diseases / Q000209:etiology; D000063:Accidents, Traffic; D001807:Blood Vessel Prosthesis; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D020216:Carotid-Cavernous Sinus Fistula / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography; D006259:Craniocerebral Trauma / Q000150:complications*; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011237:Predictive Value of Tests; D019919:Prosthesis Implantation / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods*