Transethmoidal transsphenoidal approach for embolization of a carotid-cavernous fistula

Case report

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  • 1 Cerebrovascular Surgery, Neurosurgical Service, and Interventional Neuroradiology, Massachusetts General Hospital, and Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
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✓ The authors describe a case of carotid-cavernous fistula that was not treatable by the standard interventional neuroradiological techniques of transarterial or transvenous occlusion of the fistula because access was blocked by prior trapping procedures. Access to the venous side of the fistula was gained by means of a transethmoidal transsphenoidal exposure, making it possible to embolize the lesion with coils. The details of this approach are described.

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Contributor Notes

Address for Dr. Pile-Spellman: Columbia Presbyterian College of Physicians and Surgeons, New York, New York 10032.Address reprint requests to: Christopher S. Ogilvy, M.D., Cerebrovascular Surgery, Neurosurgical Service, Massachusetts General Hospital, Fruit Street, Boston, Massachusetts 02114.
  • 1.

    Bitoh S, , Hasegawa H, & Fujiwara M, et al: Irradiation of spontaneous carotid-cavernous fistulas. Surg Neurol 17:282286, 1982 Bitoh S, Hasegawa H, Fujiwara M, et al: Irradiation of spontaneous carotid-cavernous fistulas. Surg Neurol 17:282–286, 1982

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  • 2.

    Debrun GM: Treatment of traumatic carotid-cavernous fistula using detachable balloon catheters. AJNR 4:355356, 1983 Debrun GM: Treatment of traumatic carotid-cavernous fistula using detachable balloon catheters. AJNR 4:355–356, 1983

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    • Export Citation
  • 3.

    Garcia-Cervigon E, , Bien S, & Laurent A, et al: Treatment of a recurrent traumatic carotid-cavernous fistula: vertebrobasilar approach after surgical occlusion of the internal carotid artery. Neuroradiology 30:355357, 1988 Garcia-Cervigon E, Bien S, Laurent A, et al: Treatment of a recurrent traumatic carotid-cavernous fistula: vertebrobasilar approach after surgical occlusion of the internal carotid artery. Neuroradiology 30:355–357, 1988

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    • Export Citation
  • 4.

    Halbach VV, , Higashida RT, & Hieshima GB, et al: Transvenous embolization of direct carotid cavernous fistulas. AJNR 9:741747, 1988 Halbach VV, Higashida RT, Hieshima GB, et al: Transvenous embolization of direct carotid cavernous fistulas. AJNR 9:741–747, 1988

    • Search Google Scholar
    • Export Citation
  • 5.

    Lasjaunias P, & Berenstein A: Arteriovenous fistulas (AVFs), in: Surgical Neuroangiography, Vol 2: Endovascular Treatment of Craniofacial Lesions. New York: Springer-Verlag, 1987, pp 175235 Lasjaunias P, Berenstein A: Arteriovenous fistulas (AVFs), in: Surgical Neuroangiography, Vol 2: Endovascular Treatment of Craniofacial Lesions. New York: Springer-Verlag, 1987, pp 175–235

    • Search Google Scholar
    • Export Citation
  • 6.

    LeRoux PD, , Elliott JP, & Eskridge JM, et al: Intraoperative angiography and temporary balloon occlusion facilitating surgical obliteration of a traumatic carotid cavernous fistula: a case report. Surg Neurol 34:260265, 1990 LeRoux PD, Elliott JP, Eskridge JM, et al: Intraoperative angiography and temporary balloon occlusion facilitating surgical obliteration of a traumatic carotid cavernous fistula: a case report. Surg Neurol 34:260–265, 1990

    • Search Google Scholar
    • Export Citation
  • 7.

    Loyo M, , Sanches-Marle JF, & Del Valle R, et al: The transnasal approach to the cavernous sinus, in Dolenc VV (ed): The Cavernous Sinus. New York: Springer-Verlag, 1987, pp 397403 Loyo M, Sanches-Marle JF, Del Valle R, et al: The transnasal approach to the cavernous sinus, in Dolenc VV (ed): The Cavernous Sinus. New York: Springer-Verlag, 1987, pp 397–403

    • Search Google Scholar
    • Export Citation
  • 8.

    Nishijima M, , Kamiyama K, & Oka N, et al: Electrothrombosis of spontaneous carotid-cavernous fistula by copper needle insertion. Neurosurgery 14:400405, 1984 Nishijima M, Kamiyama K, Oka N, et al: Electrothrombosis of spontaneous carotid-cavernous fistula by copper needle insertion. Neurosurgery 14:400–405, 1984

    • Search Google Scholar
    • Export Citation
  • 9.

    Parkinson D: Transcavernous repair of carotid cavernous fistula: case report. J Neurosurg 26:420424, 1967 Parkinson D: Transcavernous repair of carotid cavernous fistula: case report. J Neurosurg 26:420–424, 1967

    • Search Google Scholar
    • Export Citation
  • 10.

    Shimizu T, , Waga S, & Kojima T, et al: Transvenous balloon occlusion of the cavernous sinus: an alternative therapeutic choice for recurrent traumatic carotid-cavernous fistulas. Neurosurgery 22:550553, 1988 Shimizu T, Waga S, Kojima T, et al: Transvenous balloon occlusion of the cavernous sinus: an alternative therapeutic choice for recurrent traumatic carotid-cavernous fistulas. Neurosurgery 22:550–553, 1988

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    • Export Citation
  • 11.

    Teng MMH, , Guo WY, & Lee LS, et al: Direct puncture of the cavernous sinus for obliteration of a recurrent carotid-cavernous fistula. Neurosurgery 23:104107, 1988 Teng MMH, Guo WY, Lee LS, et al: Direct puncture of the cavernous sinus for obliteration of a recurrent carotid-cavernous fistula. Neurosurgery 23:104–107, 1988

    • Search Google Scholar
    • Export Citation

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