title: Usefulness of intravascular ultrasonography monitoring of coil embolization for traumatic direct carotid-cavernous fistula-case report-.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan. m3275727@med.osaka-cu.ac.jp
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nishio
authors.forename: Taichiro
authors.initials: T
authors.lastname: Kawakami
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Mitsuhashi
authors.forename: Koji
authors.initials: K
authors.lastname: Hayasaki
authors.forename: Miki
authors.initials: M
authors.lastname: Kiyama
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tada
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohata
mesh_terms: 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*