Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Aug 25:2015:bcr2015011786.
doi: 10.1136/bcr-2015-011786.

Treatment of post-traumatic carotid-cavernous fistulas using pipeline embolization device assistance

Nisha Pradeep  1 , Robert Nottingham  1 , Anthony Kam  1 , Dheeraj Gandhi  2 , Nasser Razack  1
Affiliations
Case Reports

Treatment of post-traumatic carotid-cavernous fistulas using pipeline embolization device assistance

Nisha Pradeep et al. BMJ Case Rep. .

Abstract

This report describes two cases of post-traumatic, high flow carotid-cavernous fistulas that demonstrated residual shunting after initial embolization with coils and Onyx, and that were successfully closed with pipeline embolization devices. Following their combined endovascular treatments, the patients experienced clinical improvement of symptoms with durable obliteration of the fistulous communications.

Keywords: CT Angiography; Fistula; Flow Diverter; Intervention; Liquid Embolic Material.

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A) Lateral and (B) oblique views of the left internal carotid artery show a direct carotid–cavernous fistula. (C) Lateral post-procedure angiogram shows successful endovascular repair with the assistance of pipeline embolization devices. (D) Three month follow-up angiogram shows resolution of the left, direct carotid–cavernous fistula.
Figure 2
Figure 2
(A) Initial lateral projection of the left internal carotid artery indicates a large, direct carotid–cavernous fistula. (B) Lateral view following pipeline embolization devices deployment across the left petrous cavernous junction demonstrates markedly reduced but persistent arteriovenous shunting. (C) Lateral view of the 7 month follow-up angiogram shows resolution of the fistulous communication.
See this image and copyright information in PMC

References

    1. Chun GFH, Tomsick TA. Transvenous embolization of a direct carotid cavernous fistula through the pterygoid plexus. AJNR Am J Neuroradiol 2002;23:1156–9. - PMC - PubMed
    1. Linfante I, Lin E, Knott E et al. . Endovascular repair of direct carotid-cavernous fistula in Ehlers-Danlos type IV. J Neurointervent Surg 2015;7:e3 10.1136/neurintsurg-2013-010990.rep - DOI - PubMed
    1. Zaidat OO, Lazzaro MA, Niu T et al. . Multimodal endovascular therapy of traumatic and spontaneous carotid cavernous fistula using coils, n-BCA, Onyx and stent graft. J Neurointervent Surg 2011;3:255–62. 10.1136/jnis.2010.003103 - DOI - PubMed
    1. Miller NR. Clinical neuro-opthalmology. Vol 1, 6th edn Philadelphia, USA: Lippincott Williams & Wilkins, 2005:2263–96.
    1. Nadarajah M, Power M, Barry B et al. . Treatment of a traumatic carotid-cavernous fistula by the sole use of a flow diverting stent. J NeuroIntervent Surg 2012;4:e1 10.1136/neurintsurg-2011-010000 - DOI - PubMed

Publication types

MeSH terms