Endovascular treatment of a traumatic direct carotid-cavernous fistula using the Amplatzer Vascular Plug II.
OBJECTIVE
To report the use of the second-generation Amplatzer Vascular Plug II (AVP II) for the treatment of a posttraumatic type A carotid-cavernous fistula (CCF).


METHODS
To achieve complete treatment of a CCF, the decision was taken to occlude the parent carotid artery after angiographic assessment. A 6-mm AVP II was deployed in the petrous segment of the ICA. Post-deployment angiography revealed minimal residual flow, so a first-generation AVP I was also deployed. Immediate flow cessation was achieved, without residual proximal or distal inflow from the contralateral side to the fistula. At 8 months, the size of the right cavernous sinus had significantly reduced, with complete occlusion of the ICA and no residual flow in the fistula.


CONCLUSIONS
The AVP II may be a useful complementary device in the neurointerventional armamentarium for parent artery occlusion.
Mordasini
Pasquale
P
Institute of Diagnostic and Interventional Neuroradiology, University Hospital Inselspital Bern, Switzerland. jan.gralla@insel.ch
Schroth
Gerhard
G
Brekenfeld
Caspar
C
Fung
Christian
C
Hoppe
Hanno
H
Gralla
Jan
J
D000063:Accidents, Traffic; D000328:Adult; D015901:Angiography, Digital Subtraction; D020216:Carotid-Cavernous Sinus Fistula / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation*; D002533:Cerebral Angiography; D004867:Equipment Design; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D012039:Regional Blood Flow; D016896:Treatment Outcome