title: Advances in the endovascular treatment of direct carotid-cavernous fistulas.
abstract: Carotid cavernous fistulas (CCFs) are abnormal connections between the carotid artery and the cavernous sinus. They are considered direct when there is a direct connection between the internal carotid artery and the cavernous sinus. These cases are generally traumatic. Direct CCFs are high-flow lesions, possibly related to intracranial bleeding, visual loss, corneal exposure or even fatal epistaxis. Treatment of such lesions is, thus, always recommended. The ideal treatment for direct CCF is to exclude the fistula from circulation, preserving the carotid flow. This can be attained using diverse endovascular techniques. The objective of the present article is to review the current techniques for treatment of direct CCFs, with special attention to the currently available endovascular treatment options.
authors.affiliation: Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
authors.forename: Guilherme Brasileiro
authors.initials: GB
authors.lastname: de Aguiar
authors.affiliation: Department of Surgery, Faculdade de Medicina, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
authors.forename: Maurício
authors.initials: M
authors.lastname: Jory
authors.affiliation: Department of Surgery, Faculdade de Medicina, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
authors.forename: João Miguel de Almeida
authors.initials: JM
authors.lastname: Silva
authors.affiliation: Department of Surgery, Faculdade de Medicina, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
authors.forename: Mario Luiz Marques
authors.initials: ML
authors.lastname: Conti
authors.affiliation: Department of Surgery, Faculdade de Medicina, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
authors.forename: José Carlos Esteves
authors.initials: JC
authors.lastname: Veiga
mesh_terms: D000792:Angiography / Q000379:methods; D021721:Balloon Occlusion / Q000379:methods; D002343:Carotid Artery, Internal / Q000601:surgery*; D020216:Carotid-Cavernous Sinus Fistula / Q000175:diagnosis / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods* / Q000639:trends; D006801:Humans