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Carotid Cavernous Fistula

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Abstract

Carotid cavernous fistulas (CCF) are complex lesions involving the abnormal shunting of arterial blood into the cavernous sinus. There are two distinct types: one is a direct communication between the internal carotid artery and the cavernous sinus, while the other is a dural shunt involving meningeal branches of the external and/or internal carotid arteries. Resulting patient symptoms as well as potential complications is determined primarily by the degree of arteriovenous shunting as well as the direction of venous outflow from the cavernous sinus. Catheter angiography remains the gold standard imaging evaluation of CCFs, although both MR and CT angiography can be used to screen patients in whom the diagnosis is suspected. Current treatment for these lesions consists primarily of conservative management and endovascular embolization. The latter can be performed via transarterial and/or transvenous approaches, using various materials such as detachable balloons, coils, and liquid embolic agents. A multidisciplinary approach, including neurointerventionalists, neurosurgeons, and ophthalmologists, is often required to achieve the best outcomes for patients.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Neuroradiology, University of Maryland Medical Center, 22 South Green Street, Baltimore, MD, 21201, USA

    Timothy R. Miller, Ravishankar Shivashankar, Gaurav Jindal & Dheeraj Gandhi

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  1. Timothy R. Miller
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  2. Ravishankar Shivashankar
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  3. Gaurav Jindal
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  4. Dheeraj Gandhi
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Correspondence to Timothy R. Miller .

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Editors and Affiliations

  1. Department of Radiology, AOU of Cagliari, Monserrato, Cagliari, Italy

    Luca Saba

  2. Neurointerventional Radiology Section, Department of Radiology, NYU Langone Medical Center, New York, NY, USA

    Eytan Raz

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Miller, T.R., Shivashankar, R., Jindal, G., Gandhi, D. (2016). Carotid Cavernous Fistula. In: Saba, L., Raz, E. (eds) Neurovascular Imaging. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9029-6_7

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  • DOI: https://doi.org/10.1007/978-1-4614-9029-6_7

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