title: [Endovascular management of cavernous sinus dural fistulas].
abstract: OBJECTIVE
  Describe the outcomes of patients diagnosed with indirect carotid-cavernous fistula treated by endovascular methods.
  
  
  METHODS
  A retrospective case series.
  
  
  METHODS
  Twelve patients with dural cavernous sinus fistula with important ophthalmologic involvement admitted and treated at the National Institute of Neurology and Neurosurgery between February 1990 and January 2005.
  
  
  METHODS
  Patients were managed by endovascular embolization for all fistulas.
  
  
  METHODS
  Angiographic controls to 24 hours and at 6 and 12 months were performed.
  
  
  RESULTS
  67 % were female and 33 % male. The mean age was 44 years. 67 % were spontaneous and 33% of traumatic origin. All patients had eye involvement with proptosis (92%) and involvement of the oculomotor nerve (67%). Headache and pulsatile tinnitus were not frequent ophthalmologic data. All were diagnosed by cerebral angiography, 33 % were type C, type D 67 %, and none of the type B classification Barrow. In 17 % of cases the distal arterial robbery showed severe. Predominance of anterior and superior venous drainage in 83 % and 42 % of cases occurred respectively. The surgical approach was arterial in 84% of cases, while in 17 % venous through the superior ophthalmic vein. Cyanoacrylate embolization material was used in 58 % of the cases, as it was associated with the use of removable ball with polyvinyl alcohol particles in 16 % in of venous approach cases. 17% detachable coils were utilized. There were no complications. After angiographic controls at 24 hours 100% occlusion was seen in patients treated with cyanoacrylate (58%) (p = 0.03). The remaining 42% were prescribed maneuver of manual compression. At 12-months angiography all patients had 100% occlusion of the carotid-cavernous fistula. CONCLSUIONS: This is the world's second largest series with indirect carotid-cavernous fistulas treated after trauma. 100 % of cases were cured with the use of a transarterial-controlled approach and N-butyl-cyanoacrylate after long-term observation.
authors.forename: Marco
authors.initials: M
authors.lastname: Zenteno
authors.forename: Jorge
authors.initials: J
authors.lastname: Santos Franco
authors.forename: Luis Rafael
authors.initials: LR
authors.lastname: Moscote-Salazar
authors.forename: Angel
authors.initials: A
authors.lastname: Lee
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods; D002342:Carotid Artery, External; D002343:Carotid Artery, Internal; D002426:Cavernous Sinus; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002533:Cerebral Angiography; D006259:Craniocerebral Trauma / Q000150:complications; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage / Q000627:therapeutic use; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D063189:Symptom Assessment; D014014:Tissue Adhesives / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014414:Tungsten / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D014014:Tissue Adhesives; D011142:Polyvinyl Alcohol; D004659:Enbucrilate; D014414:Tungsten