Transorbital hybrid approach for endovascular occlusion of indirect carotid-cavernous fistulas-Case report and systematic literature review

Bascarevic Vladimir; Vukasinovic Ivan; Nedeljkovic Zarko; Nedeljkovic Aleksandra; Milicevic Mihailo; Jovanovic Nemanja; Milic Marina; Stanimirovic Aleksandar; Scepanovic Vuk; Grujicic Danica

doi:10.1016/j.radcr.2022.06.043

Transorbital hybrid approach for endovascular occlusion of indirect carotid-cavernous fistulas-Case report and systematic literature review

Radiol Case Rep. 2022 Jul 12;17(9):3312-3317. doi: 10.1016/j.radcr.2022.06.043. eCollection 2022 Sep.

Authors

Bascarevic Vladimir^{1

2}, Vukasinovic Ivan³, Nedeljkovic Zarko¹, Nedeljkovic Aleksandra¹, Milicevic Mihailo^{1

2}, Jovanovic Nemanja¹, Milic Marina^{1

2}, Stanimirovic Aleksandar¹, Scepanovic Vuk^{1

2}, Grujicic Danica^{1

2}

Affiliations

¹ Clinic for Neurosurgery, Clinical Center of Serbia, Koste Todorovica 4, Serbia.
² Faculty of Medicine, University of Belgrade, Doktora Subotica Starijeg 8, Serbia.
³ Center for Radiology and MRI, Clinical Center of Serbia, Pasterova 2, Serbia.

Abstract

Carotid-cavernous fistulas (CCF) are vascular malformations characterized by an aberrant shunt between one or more sources of arterial inflow and the cavernous sinus (CS). They are subdivided into direct and indirect fistulas. This last one, called dural CCF involve dural fistulous connections between branches of the internal carotid artery or the external carotid artery. When conventional routes are not eligible, surgical exposure of the vein is the only access to the fistula. We present the case of a patient successfully treated for right sided dural CCF, by a hybrid approach. Furthermore, through a literature review, we analyze the possible risks and benefits associated with this approach.

Keywords: Dural carotid-cavernous fistula; Embolization; Hybrid approach; Superior ophthalmic vein cannulation.

Publication types

Case Reports