Is the retrograde access for endovascular treatment of a traumatic carotid cavernous fistula associated with dissection of the ipsilateral carotid possible?

Pagiola Igor; Amaral Bruno; Saito Celso; Nalli Darcio; Junior Henrique Carrete; Frudit Michel

doi:10.7461/jcen.2021.E2020.05.002

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저자정보: Pagiola Igor (Department of Interventional Neuroradiology Universidade Federal de São Paulo São Paulo SP Brazil) Amaral Bruno (Department of Interventional Neuroradiology Universidade Federal de São Paulo São Paulo SP Brazil) Saito Celso (Department of Interventional Neuroradiology Universidade Federal de São Paulo São Paulo SP Brazil) Nalli Darcio (Department of Interventional Neuroradiology Universidade Federal de São Paulo São Paulo SP Brazil) Junior Henrique Carrete (Department of Interventional Neuroradiology Universidade Federal de São Paulo São Paulo SP Brazil) Frudit Michel (Department of Interventional Neuroradiology Universidade Federal de São Paulo São Paulo SP Brazil)

저널정보: 대한뇌혈관외과학회 Journal of Cerebrovascular and Endovascular Neurosurgery Journal of Cerebrovascular and Endovascular Neurosurgery Vol.23 No.1

발행연도: 2021.3

수록면: 54 - 59 (6page)

DOI: 10.7461/jcen.2021.E2020.05.002

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This is a case demonstrating a combined traumatic lesion of the internal carotid artery (dissection and a carotid cavernous fistula [CCF]) in a patient who was beaten during a robbery and, while trying to escape, was hit by a vehicle. Endovascular approach for the treatment was chosen using the retrograde access from the vertebral artery to the cavernous sinus by posterior communicating (Pcom) artery due to the occlusion of the ipsilateral internal carotid. Because the artery access by the internal carotid was impossible, retrograde approach by vertebral artery and Pcom artery was done to treat the direct CCF. A patient presented with left hemiplegia and proptosis, chemosis, right eye ptosis. Computed tomography (CT) and CT angiography revealed a CCF of the right carotid. An arterial retrograde endovascular approach by the vertebral artery was used for CCF occlusion with coils. We present a rare case of a combined traumatic cerebrovascular lesion, right carotid artery dissection and a right direct CCF treated by a retrograde endovascular approach by the vertebral artery through the Pcom artery to reach the fistula point and achieved a complete cure of the CCF

#Carotid-cavernous sinus fistula #Carotid artery #Internal #Dissection #Endovascular procedures

참고문헌 (15)

참고문헌 신청

Barrow DL / 1985 / Classification and treatment of spontaneous carotid-cavernous sinus fistulas / J Neurosurg 62(2):248~256

Biffl WL / 1998 / The unrecognized epidemic of blunt carotid arterial injuries : early diagnosis improves neurologic outcome / Ann Surg 228(4):462~470

Chen CC / 2005 / CT angiography and MR angiography in the evaluation of carotid cavernous sinus fistula prior to embolization : a comparison of techniques / AJNR Am J Neuroradiol 26(9):2349~2356

Debrun GM / 1995 / Access to the cavernous sinus through the vertebral artery : technical case report / Neurosurgery 37(1):144~146

De Campos JM / 1982 / Spontaneous carotid-cavernous fistula in osteogenesis imperfecta / J Neurosurg 56(4):590~593

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