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Journal of Neuroradiology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 22 juillet 2011
Doi : 10.1016/j.neurad.2011.05.007
Embolization of carotid-cavernous fistula via direct percutaneous puncture of the inferior ophthalmic vein
Embolisation d’une fistule carotido-caverneuse après ponction directe percutanée de la veine ophtalmique inférieure
 

Michelle M. Cecchini a, ⁎ , Michael R. Levitt a, Manish Taneja b, Danial K. Hallam a, b, Basavaraj V. Ghodke a, b
a Box 359924, Department of Neurological Surgery, University of Washington and Harborview Medical Center, 1959 NE Pacific Street, Seattle, WA 98195, USA 
b Department of Radiology, University of Washington and Harborview Medical Center, 1959 NE Pacific Street, Seattle, WA 98195, USA 

Corresponding author. Tel.: +206 543 3570; fax: +206 543 8315.
Summary

Carotid-cavernous fistulas (CCFs) are anomalous connections between the carotid circulation and the cavernous sinus, and may cause significant morbidity. Endovascular treatment of these lesions can be challenging if typical transvenous routes are inaccessible. We describe a case of a Barrow type D carotid-cavernous fistula in which transvenous embolization was attempted via the inferior petrosal sinus (IPS). No connection was found to the fistula, and the superior ophthalmic vein (SOV) was thrombosed. A novel direct percutaneous puncture of the IOV was performed with ultrasound guidance showing that this is a safe alternative route of CCF access and embolization when the IPS and SOV are inaccessible.


Keywords : Carotid-cavernous sinus fistula, Therapeutic embolization, Inferior ophthalmic vein


OutlineMasquer le plan
Introduction
Case report/Technique
Discussion
Conclusion
Disclosure of interest


© 2011  Published by Elsevier Masson SAS.
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