Clinical Outcomes of Endovascular Treatment for Carotid Cavernous Sinus Fistula at a Tertiary Hospital

Abstract

Background: A carotid-cavernous sinus fistula (CCF) is an abnormal arteriovenous communication between the cavernous sinus and the internal carotid artery (ICA) and or external carotid artery (ECA). The goal of endovascular treatment is the closure of the fistula with preservation of carotid artery patency.

Purpose: To report clinical outcomes using embolic material for the treatment of patients with CCF.

Design: Retrospective study

Materials and methods: The authors retrospectively reviewed the medical records of 25 patients with CCF that underwent the endovascular treatment and follow up from January 2015 to December 2018.

Results: Based on the angiographic characteristics following the Barrow classification, there were 15 patients of the type A CCF, 8 patients of indirect CCF and 2 patients of the combine type CCF.
The embolic materials included 48% of detachable balloon, 32% of glue, 8% of coils, and 12% of combined materials. There were 84% of complete embolization, 16% of incomplete embolization with residual fistula. Twenty-three patients (92%) of fistula were totally occluded with the preservation of the carotid artery. There were 2 patients developed stroke due to ICA insufficiency.

Conclusion: Endovascular treatment to embolize the different types of CCFs had a good successful rate with the majority of patients had improvement of the visual function.