Summary
Eight patients with nine carotid-cavernous fistulas (CCF), one of them bilateral, have been treated in our Department by embolization of the venous components of the cavernous sinus, either through one of its venous effluents or by direct puncture of the sinus, in an effort to preserve the internal carotid artery (ICA). Five of the fistulas were of traumatic origin and four were spontaneous. In two cases the cavernous sinus was embolized through bridging temporal veins, and in another two cases embolization was carried out by catheterization of the cavernous sinus via the superior ophthalmic vein, while in the remaining five cases it was performed by direct puncture of the lateral wall of the sinus. The embolizing materials employed were bone wax mixed with an oily iodised contrast media, small pieces of oxidized cellulose or gelfoam vehicled by saline solution, and fibrin sealant. Obliteration of the CCF was complete in all but one case, in which this was accomplished only partially. On six occasions carotid patency was maintained, while in two patients failure of the technique made trapping of the ICA necessary. In one patient the ICA was ligated prior to the embolization of the cavernous sinus. The surgical techniques employed and the results achieved are exposed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Parkinson D (1965) A surgical approach to the cavernous portion of the carotid artery. Anatomical studies and case report. J Neurosurg 23: 474–483.
Parkinson D (1973) Carotid-cavernous fistula: direct repair with preservation of the carotid artery. Technical note. J Neurosurg 38: 99–106.
Serbinenko FA (1974) Balloon catheterization and occlusion of major cerebral vessels. J Neurosurg 41: 125–145.
Debrun G, Lacour P, Vinuela F, et al (1981) Treatment of 54 traumatic carotid-cavernous fistulas. J Neurosurg 55: 678–692.
Vinuela F, Fox AJ, Debrun GM et al (1984) Spontaneous carotid-cavernous fistulas: clinical, radiological and therapeutic considerations. Experience with 20 cases. J Neurosurg 60: 976–984.
Peters FLM, van der Werf AJM (1980) Detachable balloon technique in the treatment of direct carotid-cavernous fistulas. Surg Neurol 14: 11–19.
Barrow DL, Fleischer AS, Hoffman JC (1982) Complications of detachable balloon catheter technique in the treatment of traumatic intracranial arteriovenous fistulas. J Neurosurg 56: 396–403.
Hosobuchi Y (1975) Electrothrombosis of carotid-cavernous fistula. J Neurosurg 42: 76–85.
Mullan S (1979) Treatment of carotid-cavernous fistulas by cavernous sinus occlusion. J Neurosurg 50: 131–144.
Isamat F, Ferrer E, Twose J (1986) Direct intracavernous obliteration of high-flow carotid-cavernous fistulas. J Neurosurg 65: 770–775.
Peterson EW, Valberg J, Whittingham DS (1970) Electrically induced thrombosis of the cavernous sinus in the treatment of carotid-cavernous fistula. In: Drake CG, Duvoisin R (eds) Fourth International Congress of Neurological Surgery, Ninth International Congress of Neurology, September 20–27, 1969, New York. Excerpta Medica, Amsterdam.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer-Verlag/Wien
About this paper
Cite this paper
Albert, P., Polaina, M., Trujillo, F., Romero, J., Durand, F. (1988). Treatment of Carotid-cavernous Fistulas by Embolization of the Cavernous Sinus Through Venous Affluents or Direct Puncture. In: Isamat, F., Jefferson, A., Loew, F., Symon, L. (eds) Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Acta Neurochirurgica Supplementum 42, vol 42. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8975-7_18
Download citation
DOI: https://doi.org/10.1007/978-3-7091-8975-7_18
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-8977-1
Online ISBN: 978-3-7091-8975-7
eBook Packages: Springer Book Archive