Carotid Cavernous Fistula: Embolization via a Bilateral Superior Ophthalmic Vein Approach

• Published in: American journal of neuroradiology : AJNR Vol. 23; no. 10; pp. 1736 - 1738
• Main Authors: Berlis, Ansgar, Klisch, Joachim, Spetzger, Uwe, Faist, Michael, Schumacher, Martin
• Format: Journal Article
• Language: English
• Published: United States Am Soc Neuroradiology 01-11-2002; American Society of Neuroradiology
• Subjects: Aged; Carotid-Cavernous Sinus Fistula - complications; Carotid-Cavernous Sinus Fistula - therapy; Embolization, Therapeutic; Eye - blood supply; Female; Humans; Interventional; Magnetic Resonance Imaging; Phlebography; Superior Vena Cava Syndrome - complications; Superior Vena Cava Syndrome - therapy; Tomography, X-Ray Computed; Vascular Surgical Procedures; Veins - surgery
• ISSN: 0195-6108; 1936-959X

We report the case of a 74-year-old woman with a complex indirect (Barrow D) carotid cavernous sinus fistula. The patient was treated incrementally and finally cured by a rarely reported bilateral retrograde direct transvenous approach via the superior ophthalmic vein. The treatment of the complex carotid cavernous fistula with multiple bilateral fistula points showed additional complexity due to a partially thrombosed left superior ophthalmic vein, which required a combined microsurgical and endovascular treatment, showing that treatment can be achieved, if necessary, by catheterization of a thrombosed orbital vein.