Abstract
An 87-year-old female patient with a 1-month history of bilateral palpebral edema and conjunctival injection was treated with antibiotics for suspected periorbital cellulitis in another health care center. Later, she developed visual loss, which progressed into amaurosis. A magnetic resonance angiography (MRA) was performed, which showed a carotid-cavernous sinus fistula (CCF), after which the patient was referred to our center for endovascular treatment. Digital subtraction angiography (DSA) was performed and revealed the presence of a direct carotid-cavernous sinus fistula being supplied by the right internal carotid artery (ICA) and draining through the ipsilateral ophthalmic vein and both inferior petrosal sinuses. Endovascular treatment was performed via a transarterial approach. The shunt was identified and completely halted using balloon-assisted coiling. Despite the removal of the arteriovenous fistula, the patient remained blind. The endovascular treatment of a direct CCF fistula and a literature review of other treatment options are the main topics of this chapter.
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Rodas, D.B., Lylyk, P.N., Lylyk, I., Lundquist, J., Lylyk, P. (2021). Direct Carotid-Cavernous Fistula: Endovascular Treatment of a Direct Carotid-Cavernous Fistula with Transarterial Balloon-Assisted Coil Occlusion. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Arteriovenous Malformations and Fistulas Casebook. Springer, Cham. https://doi.org/10.1007/978-3-030-51200-2_8-1
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