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Comparison of polyvinyl alcohol copolymer with detachable balloons for the embolisation of direct carotid cavernous fistula: a single-centre experience

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Abstract

Objectives

To characterise the safety, efficacy and cost of direct carotid-cavernous fistula (CCF) treatment using polyvinyl alcohol copolymer or detachable balloons.

Methods

We reviewed retrospectively patients with direct CCFs treated with either a detachable balloon or polyvinyl alcohol copolymer at our hospital from 2005 to 2015 and identified 94 patients with 105 CCFs. All patients had follow-up angiograms. The CCF occlusion rate, procedure complication rate, treatment expense and operation time were recorded.

Results

With a mean of 5.4 months of angiographic follow-up, the complete occlusion rate and recanalisation rate of the polyvinyl alcohol copolymer group was not significantly different from that of the detachable balloon group. The treatment expense was much higher and the operation time was much longer in the polyvinyl alcohol copolymer group than the detachable balloon group (P < 0.001).

Conclusions

Embolisation of CCF with polyvinyl alcohol copolymer is as safe and effective as detachable balloon but has a much higher cost and longer operation time.

Key Points

• Carotid-cavernous fistula results from a damaged carotid artery.

• Detachable balloons have been used with success for many years.

• Some reported excellent outcomes after embolisation with polyvinyl alcohol copolymer.

• Treatment expense is much higher in the polyvinyl alcohol copolymer group.

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Acknowledgments

We would like to acknowledge further polishing to improve the literary beauty of the language and the rationality of the content received from Dr. Lei Feng (Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA), and the helpful comments on this article received from the reviewers.

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Authors and Affiliations

  1. Department of Neurosurgery, Zhujiang Hospital of Southern Medical University, National clinical key subject, Guangdong Provincial Clinical Medical Centre Department of Neurosurgery, Guangzhou, 510282, China

    Xuying He, Chuanzhi Duan, Lingfeng Lai, Xin Zhang, Zhenjun Li, Xifeng Li & Tielin Li

Authors
  1. Xuying He
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  2. Chuanzhi Duan
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  3. Lingfeng Lai
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  4. Xin Zhang
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  5. Zhenjun Li
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  6. Xifeng Li
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  7. Tielin Li
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Corresponding author

Correspondence to Xuying He.

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Guarantor

The scientific guarantor of this publication is Chuanzhi Duan.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by National Natural Science Foundation of China (81400943) and Medical Scientific Research Foundation of Guangdong Province, China (QD2013NO11).

Statistics and biometry

Zhenjun Li and Lingfeng Lai kindly provided statistical advice for this manuscript.

Informed consent

The consent about the procedure and embolical material was signed by each patient.

Ethical approval

Our institution does not require IRB approval for this type of retrospective and written informed consents were obtained from all patients before the endovascular treatment. This study was performed under the supervision of the Institutional Review Board of Zhujiang Hospital of Southern Medical University.

Methodology

Retrospective, observational study; performed at one institution.

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He, X., Duan, C., Lai, L. et al. Comparison of polyvinyl alcohol copolymer with detachable balloons for the embolisation of direct carotid cavernous fistula: a single-centre experience. Eur Radiol 27, 4730–4736 (2017). https://doi.org/10.1007/s00330-017-4864-2

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  • DOI: https://doi.org/10.1007/s00330-017-4864-2

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