, Volume 34, Issue 1, pp 77–80 | Cite as

Treatment of type D dural carotid-cavernous fistula by embolization followed by irradiation

  • L. Pierot
  • M. Poisson
  • M. Jason
  • D. Pontvert
  • J. Chiras
Interventional Neuroradiology


In a patient with dural carotid-cavernous fistula supplied by meningeal branches of both internal and external carotid arteries, particulate embolization of the meningeal branches of only the external carotid artery failed to cure the fistula. Subsequent radiation therapy achieved clinical and anatomical cure of the lesion.

Key words

Carotid-cavernous fistula Dural fistula Transvascular embolization Radiation therapy 


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  1. 1.
    Barrow DL, Sector RH, Braun IF, Landman J, Tindall SC, Tindall GT (1985) Classification and treatment of spontaneous carotid-cavernous fistula. J Neurosurg 62: 248–256Google Scholar
  2. 2.
    Debrun GM, Vinuela F, Fox AJ, Davis KR, Ahn HS (1988) Indications for treatment and classifications of 132 carotid-cavernous fistulas. Neurosurgery 22: 285–289Google Scholar
  3. 3.
    Higashida RT, Halbach VV, Tsai FY, Norman D, Pribram HF, Mehringer CM, Hieshima GB (1989) Interventional neurovascular treatment of traumatic carotid and vertebral artery lesions. AJR 153: 577–582Google Scholar
  4. 4.
    Halbach VV, Higashida RT, Hieshima GB, Reicher M, Norman D, Newton TH (1987) Dural fistulas involving the cavernous sinus: results of treatment in 30 patients. Radiology 163: 437–442Google Scholar
  5. 5.
    Halbach VV, Higashida RT, Hieshima GB, Hardin CW, Pribram H (1989) Transvenous embolization of dural fistulas involving the cavernous sinus. AJNR 10: 377–383Google Scholar
  6. 6.
    Vinuela F, Fox AJ, Debrun GM, Peerless SJ, Drake CG (1984) Spontaneous caroid-cavernous fistulas: clinical, radiological, and therapeutic considerations. J Neurosurg 60: 976–984Google Scholar
  7. 7.
    Labbe D, Courtheoux P, Rigot-Jolivet M, Compere JF, Theron J (1987) Bilateral dural carotid-cavernous fistula. Its treatment by way of the superior ophthalmic vein. Rev Stomatol Chir Maxillofac 88: 120–124Google Scholar
  8. 8.
    Suzuki J, Komatsu S (1981) New embolization method using estrogen for dural arteriovenous malformation and meningioma. Surg Neurol 16: 438–442Google Scholar
  9. 9.
    Hosobuchi Y (1975) Electrothrombosis of carotid-cavernous fistula. J Neurosurg 12: 76–84Google Scholar
  10. 10.
    Mullan S (1979) Treatment of carotid-cavernous fistulas by cavernous sinus occlusion. J Neurosurg 50: 131–144Google Scholar
  11. 11.
    Ishikawa M, Handa H, Taki W, Yoneda S (1982) Management of spontaneous carotid-cavernous fistulas. Surg Neurol 18: 131–139Google Scholar
  12. 12.
    Halbach VV, Higashida RT, Hieshima GB, Hardin CW, Yang PJ (1988) Transvenous embolization of direct carotid cavernous fistulas. AJNR 9: 741–747Google Scholar
  13. 13.
    Hanneken AM, Miller NR, Debrun GM, Nauta HJ (1989) Treatment of carotid-cavernous sinus fistulas using detachable balloon catheter through the superior ophthalmic vein. Arch Ophthalmol 107: 87–92Google Scholar
  14. 14.
    Uflacker R, Lima S, Ribas GC, Piske RL (1986) Carotid-cavernous fistulas: embolization through the superior ophthalmic vein approach. Radiology 59: 175–179Google Scholar
  15. 15.
    Bitoh S, Hasegawa H, Fujiwara M, Nakao K (1982) Irradiation of spontaneous carotid-cavernous fistulas. Surg Neurol 17: 282–286Google Scholar
  16. 16.
    Colombo F, Benedetti, Pozza F, Marchetti C, Chierego G (1989) Linear accelerator radiosurgery of cerebral arteriovenous malformations. Neurosurgery 24: 833–840Google Scholar
  17. 17.
    Ogilvy CS (1990) Radiation therapy for arteriovenous malformations: a review. Neurosurgery 26: 725–735Google Scholar
  18. 18.
    Brant-Zawadzki M, Anderson M, Deramond SJ, Conley FK, Jahnke RW (1980) Radiation-induced large intracranial vessel occlusive vasculopathy. AJR 134: 51–55Google Scholar
  19. 19.
    Groothuis DR, Mickael MA (1986) Focal cerebral vasculitis associated with circulating immune complexes and brain irradiation. Ann Neurol 19: 590–592Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • L. Pierot
    • 1
  • M. Poisson
    • 2
  • M. Jason
    • 1
  • D. Pontvert
    • 3
  • J. Chiras
    • 1
  1. 1.Department de NeuroradiologieG. H. Pitie-SalpetriereParisFrance
  2. 2.Service de NeurologieG. H. Pitie-SalpetriereParisFrance
  3. 3.Service de RadiotherapieInstitute CurieParisFrance

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