Embolization of Four Cases of Carotid-Cavernous Sinus Fistulas by Retrograde Catheterism of the Superior Orbital Vein

  • J. P. Caron
  • Y. Raulo
  • A. Gaston
  • P. Lasjaunias
  • J. Courtheoux
Conference paper


According to Dolenc [9] Mont as early as 1935 advocated in cases of carotid- cavernous sinus fistulas (CCSF) with anterior drainage through the superior orbital vein (SOV) the resection and ligature of this vein. He suggested scouring the lumen with a small tube brush soaked in 50% glucose. Also, as described by Dolenc, Brainerd in 1953 attempted to cure an “erectile tumor of the orbit” by retrograde injection of lactate of iron. Dandy et al. in 1937 [3] and 1941 [4] expressed the opinion that the SOV route should not be used for treating CCSF. In 1975 Peterson et al. [11] used a percutaneous approach for passing through the SOV to treat successfully CCSF. In 1981 Debrun et al. [6] maintained that the endovenous route was an excellent way to treat CCSF drained anteriorly through the SOV; however, their first percutaneous approaches failed, and in 1983 [7] Debrun wrote that “retrograde navigation through the SOV was virtually impossible in cases of CCSF with totally or mainly anterior drainage through the ophthalmic veins.” But they were recently successful [8], in two cases using a surgical approach. In fact, Uflacker et al. [13] in 1986 published the most important article on retrograde catheterism through the SOV for treating CCSF drained anteriorly, presenting three successful cases out of five by a surgical approach “deep in the orbit.” Since this article, very few cases of CCSF embolization through the SOV have been published. Here we present four such cases, coming from three different French neuroradiological and neurosurgical teams.


Internal Carotid Artery Percutaneous Approach Superior Ophthalmic Vein Orbital Pain Retrograde Catheterism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Barrow DL, Spector RH, Braun EF, Landman J A, Tindall SC, Tindall GT (1985) Classification and treatment of spontaneous carotid-cavernous sinus fistulas. J Neurosurg 62: 248–256PubMedCrossRefGoogle Scholar
  2. 2.
    Bennett DR, Van Dyk HJL, Davis DO (1973) Carotid-cavernous sinus fistula closure following angiography. JAMA 224: 1637–1639PubMedCrossRefGoogle Scholar
  3. 3.
    Dandy WE (1937) Carotid-cavernous aneurysms (pulsating exophthalmos). Zentralbl Neurochir 2:77–113, 165–206Google Scholar
  4. 4.
    Dandy WE, Follis RH Jr (1941) On the pathology of carotid cavernous aneurysms (pulsating exophthalmos). Am J Ophthalmol 24: 365–385Google Scholar
  5. 5.
    Debrun GM, Lacour P, Caron JP et al. (1975) Experimental approach to treatment of carotid cavernous fistulas with an inflatable and isolated balloon. Neuroradiology 9:9– 12CrossRefGoogle Scholar
  6. 6.
    Debrun G, Lacour P, Vinuela F, Fox A, Drake CG, Caron JP (1981) Treatment of 54 traumatic carotid-cavernous fistulas. J Neurosurg 55: 678–692PubMedCrossRefGoogle Scholar
  7. 7.
    Debrun G (1983) Treatment of traumatic carotid-cavernous fistula using detachable balloon catheters. AJNR 4: 355–356PubMedGoogle Scholar
  8. 8.
    Debrun G, Vinuela F, Fox AJ, Davis KR, Ahn HS (1988) Indications for treatment and classification of 132 carotid-cavernous fistulas. Neurosurgery 22: 285–289PubMedCrossRefGoogle Scholar
  9. 9.
    Dolenc W (1987) The cavernous sinus. A multidisciplinary approach to vascular and tumorous lesions. Springer, Wien New YorkGoogle Scholar
  10. 10.
    Mullan S (1974) Experience with surgical thrombosis of intracranial berry aneurysms and carotidcavernous fistulas. J Neurosurg 41: 657–670PubMedCrossRefGoogle Scholar
  11. 11.
    Peterson E, Valberg JD, Ventureyra E (1975) Percutaneous treatment of carotid cavernous fistula with preservation of the carotid artery. Presented at the Canadian Meeting of Neurological Sciences, June 19, 1975Google Scholar
  12. 12.
    Tress BM, Thompson KR, Klug GL, Mee RRB, Crawford B (1983) Management of carotid-cavernous fistulas by surgery combined with interventional radiology. J Neurosurg 159: 1076–1081Google Scholar
  13. 13.
    Uflacker R, Lima S, Ribas GC, Piske RL (1986) Carotid-cavernous fistulas: embolization through the superior ophthalmic vein approach. Radiology 159: 275–179Google Scholar
  14. 14.
    Vinuela F, Lylyk P (1987) Endovascular therapy of vascular lesions of the cavernous sinus. Experience with 129 cases. In: Dolenc W (ed) The cavernous sinus. A multidisciplinary approach to vascular and tumorous lesions. Springer, Wien New YorkGoogle Scholar
  15. 15.
    Voigt K, Sauer M, Dichgans J (1971) Spontaneous occlusion of a bilateral carotid- cavernous fistula studied by serial angiography. Neuroradiology 2: 207–211PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • J. P. Caron
    • 1
  • Y. Raulo
    • 1
  • A. Gaston
    • 1
  • P. Lasjaunias
    • 2
  • J. Courtheoux
    • 3
  1. 1.CreteilFrance
  2. 2.Le Kremlin-BicetreFrance
  3. 3.CaenFrance

Personalised recommendations