title: Follow-up of 58 traumatic carotid-cavernous fistulas after endovascular detachable-balloon embolization at a single center.
abstract: OBJECTIVE
  This study evaluated the clinical value of detachable-balloon embolization for traumatic carotid-cavernous fistula (TCCF), focusing on the frequency, risk factors, and retreatment of recurrence.
  
  
  METHODS
  Fifty-eight patients with TCCF underwent transarterial detachable-balloon embolization between October 2004 and March 2011. The clinical follow-up was performed every 3 months until up to 3 years postprocedure. Each patient was placed in either the recurrence group or the nonrecurrence group according to whether a recurrence developed after the first procedure. The relevant factors including gender, fistula location, interval between trauma and the interventional procedure, blood flow in the carotid-cavernous fistula, number of balloons, and whether the internal carotid artery (ICA) was sacrificed were evaluated.
  
  
  RESULTS
  All 58 TCCFs were successfully treated with transarterial balloon embolization, including 7 patients with ICA sacrifice. Recurrent fistulas occurred in seven patients during the follow-up period. Univariate analysis indicated that the interval between trauma and the interventional procedure (p=0.006) might be the main factor related to the recurrence of TCCF. The second treatments involved ICA sacrifice in two patients, fistula embolization with balloons in four patients, and placement of a covered stent in one patient.
  
  
  CONCLUSIONS
  Detachable balloons can still serve as the first-line treatment for TCCFs and recurrent TCCFs despite having a nonnegligible recurrence rate. Shortening the interval between trauma and the interventional procedure may reduce the risk of recurrence.
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Xiao-Quan
authors.initials: XQ
authors.lastname: Xu
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.forename: Qing-Quan
authors.initials: QQ
authors.lastname: Zu
authors.forename: Lin-Bo
authors.initials: LB
authors.lastname: Zhao
authors.forename: Jin-Guo
authors.initials: JG
authors.lastname: Xia
authors.forename: Chun-Gao
authors.initials: CG
authors.lastname: Zhou
authors.forename: Wei-Zhong
authors.initials: WZ
authors.lastname: Zhou
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Shi
keywords: detachable balloons; interventional procedure; recurrence; traumatic carotid-cavernous fistula