Treatment of post-traumatic carotid-cavernous fistulas with the Willis covered stent. A preliminary prospective study.
We describe our preliminary experience on the feasibility of using the Willis covered stent in patients with carotid-cavernous fistulas (CCFs). Eleven consecutive patients with post-traumatic CCFs referred for treatment with Willis covered stents were enrolled into this prospective study, and were subsequently followed-up at our hospital. Data on technical success, initial and final angiographic results, mortality, morbidity and final clinical outcome, was collected, with follow-up performed at one, three, six and 12 months, and yearly thereafter. Deployment of the covered stents was technically successful in all patients. Angiographic results following stent placement showed a complete occlusion in eight patients with ten CCFs, and an incomplete occlusion in three. No adverse events occurred either during or after the procedure. Angiographic follow-up (mean 14.73 ± 6.77 months) revealed complete occlusion and no obvious in-stent stenosis in all patients. Clinical follow-up (mean 17.73 ± 6.48 months) demonstrated full recovery in ten patients, and improvement in one. These preliminary results indicate that the use of the Willis covered stent is a feasible procedure, and that it may therefore serve as an alternative treatment for CCFs. Longer follow-up assessments and an expanded clinical trial are needed.
Department of Interventional Radiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China. hanxinwei@tom.com
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D000293:Adolescent; D000328:Adult; D020216:Carotid-Cavernous Sinus Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002533:Cerebral Angiography; D020099:Coated Materials, Biocompatible; D006259:Craniocerebral Trauma / Q000150:complications*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional; D015607:Stents; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible