P-026 Endovascular Treatment as a Resolutive Method of Carotid-Cavernous Fistulas with Detachable Balloons

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Abstract

Introduction

The cavernous sinus (CS) is a complex structure that has been studied since decades. An abnormal communication between the Carotid Artery and the CS is known as Carotid-Cavernous Fistula (CCF) which diagnosis and treatment is a challenge. The shunt location, flow type and its aetiology allows its appropriate classification. The endovascular treatment with balloons is used since the 70's by Servinenko. In this series, we use detachable balloons (DB) for a resolutive treatment of the CCF.

Methods

We made a retrospective study from March 2007 to March 2013 in a single hospital in Monterrey Mexico. We enrolled patients with direct CCF. We examined the demographic, clinic and angiographic features.

Results

We included 38 patients, 8 women (21.05%), 30 men (78.95%). The most common aetiology was a traumatic brain injury (TBI) in 26 patients (68%). The bruit and exophthalmos were found in 84.21% and 81.57%, respectively. A complete embolization of the CCF was done on 97% of the patients on the first procedure and 100% in the second one; all successful results were confirmed with angiographic monitoring at 6 months. We report 4 complications inherent to the procedure and no decease were presented. A positive correlation between the safety and effectiveness was found with the endovascular usage of DB in patients with direct CCF.

Conclusions

In our experience, detachable balloons are an effective and safety endovascular alternative in the treatment of direct carotid-cavernous fistula.

Disclosures

J. Figueroa-Sanchez: None. A. Martinez-Ponce de Leon: None.

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