Combined surgery and endovascular treatment of complicated traumatic carotid-cavernous fistulas: Results and illustrated cases.

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dc.contributor.authorWitthiwej, Theerapol
dc.contributor.authorTisavipat, Nanthasak
dc.contributor.authorSaesue, Prajak
dc.contributor.authorNanta-Aree, Sarun
dc.contributor.authorLuxsuwong, Montri
dc.contributor.authorChanyavanich, Voravut
dc.contributor.authorChiewvit, Pipat
dc.contributor.authorChurojana, Anchalee
dc.contributor.authorSuttipongchai, Suttisak
dc.date.accessioned2012-02-10T08:40:52Z
dc.date.available2012-02-10T08:40:52Z
dc.date.issued2006-06
dc.description.abstractObjective: To review Siriraj Hospital’s experiences with direct surgical treatment of complicated traumatic carotid-cavernous fistulas (CCFs) in the context of multidisciplinary approach. Methods: This study is a retrospective review of complicated direct carotid cavernous fistulas (CCFs) that had opened surgery after failure of detachable balloon embolization. Data were collected from medical records, radio-angiographic records, and follow-up results of combinations of treatment. Results: From 1993- April 2003, we have total 25 cases of combined surgery and endovascular treatment of traumatic carotid-cavernous fistulas (CCFs). Causes of unsuccessful balloon embolization are small-hole fistula, deflation of the balloon, difficult position of fistula, false aneurysm, risk of intracavernous internal carotid artery (ICA) occlusion, and tortuosity of ICA and draining veins. Various procedures were performed and all patients have good results with completed resolution of clinical triad symptoms. On follow-up cerebral angiography of 16 patients that received cavernous sinus packing, we could preserve the patency of ICA in 8 patients but 5 patients had thrombosis of ICA without ischemic events. In 3 patients, an operation to occlude the ICA was performed after failure of cavernus sinus packing. Conclusions: The standard treatment of carotid cavernous fistula is endovascular balloon embolization. When the endovascular treatment fails, surgical packing of cavernous sinus is immediately considered an alternative way to cure the CCFs and to offer additional technique to help increase the patency of ICA.en_US
dc.identifier.citationWitthiwej Theerapol, Tisavipat Nanthasak, Saesue Prajak, Nanta-Aree Sarun, Luxsuwong Montri, Chanyavanich Voravut, Chiewvit Pipat, Churojana Anchalee, Suttipongchai Suttisak. Combined surgery and endovascular treatment of complicated traumatic carotid-cavernous fistulas: Results and illustrated cases. Siriraj Medical Journal, 2006 June; 58(6): 853-860.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/136920
dc.language.isoenen_US
dc.source.urihttps://www.sirirajmedj.com/content_download.php?content_id=1967en_US
dc.subjectBalloon embolizationen_US
dc.subjectCarotid cavernous fistulasen_US
dc.subjectCavernous sinus packingen_US
dc.subjectEndovascular treatmenten_US
dc.titleCombined surgery and endovascular treatment of complicated traumatic carotid-cavernous fistulas: Results and illustrated cases.en_US
dc.typeArticleen_US
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