title: Endovascular treatment of carotid cavernous sinus fistula: A systematic review.
abstract: Carotid cavernous sinus fistulas are abnormal communications between the carotid system and the cavernous sinus. Several classification schemes have described carotid cavernous sinus fistulas according to etiology, hemodynamic features, or the angiographic arterial architecture. Increased pressure within the cavernous sinus appears to be the main factor in pathophysiology. The clinical features are related to size, exact location, and duration of the fistula, adequacy and route of venous drainage and the presence of arterial/venous collaterals. Noninvasive imaging (computed tomography, magnetic resonance, computed tomography angiography, magnetic resonance angiography, Doppler) is often used in the initial work-up of a possible carotid cavernous sinus fistulas. Cerebral angiography is the gold standard for the definitive diagnosis, classification, and planning of treatment for these lesions. The endovascular approach has evolved as the mainstay therapy for definitive treatment in situations including clinical emergencies. Conservative treatment, surgery and radiosurgery constitute other management options for these lesions.
authors.affiliation: Bora Korkmazer, Burak Kocak, Civan Islak, Naci Kocer, Osman Kizilkilic, Division of Neuroradiology, Department of Radiology, Cerrahpasa School of Medicine, Istanbul University, 34098 Istanbul, Turkey.
authors.forename: Bora
authors.initials: B
authors.lastname: Korkmazer
authors.forename: Burak
authors.initials: B
authors.lastname: Kocak
authors.forename: Ercan
authors.initials: E
authors.lastname: Tureci
authors.forename: Civan
authors.initials: C
authors.lastname: Islak
authors.forename: Naci
authors.initials: N
authors.lastname: Kocer
authors.forename: Osman
authors.initials: O
authors.lastname: Kizilkilic
keywords: Carotid cavernous sinus fistula; Cavernous sinus; Endovascular treatment