Difficult indirect carotid-cavernous fistulas--alternative techniques to gaining access for treatment
Carotid-cavernous fistulas (CCFs) are abnormal communications between the carotid arterial system and the cavernous sinus that occur mainly in elderly. Occasionally, treatment of indirect CCFs with conventional endovascular approach through large veins or the inferior petrosal sinus may not be possi...
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| Veröffentlicht in: | Clinical interventions in aging 2014-01, Vol.9, p.1687-1690 |
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| creator | El-Hindy, Nabil Kalantzis, George Patankar, Tufail Georgalas, Ilias Jyothi, Sreedar Goddard, Tony Chang, Bernard |
| description | Carotid-cavernous fistulas (CCFs) are abnormal communications between the carotid arterial system and the cavernous sinus that occur mainly in elderly. Occasionally, treatment of indirect CCFs with conventional endovascular approach through large veins or the inferior petrosal sinus may not be possible. In these cases, a direct surgical cut down on to the superior ophthalmic vein (SOV) is necessary. We describe three such cases of embolization of CCFs through SOV, and their results.
A retrospective case notes review of treated patients over the past 10 years in one tertiary center constituted our methodology.
The fistulas in two cases were successfully coiled with complete obviation of symptoms and signs. The third case was complicated due to difficulty in canulating a deeply seated vein and so had to be abandoned and catheterized through contralateral superior petrosal sinus and treated with liquid embolic material Onyx(®) successfully.
In cases where conventional access to the cavernous sinus may not be possible due to local variations of anatomy, multidisciplinary surgical approaches via the SOV provide an alternative route to successfully and safely close a CCF. However, unexpected anatomical variations could also be encountered within the SOV for which the surgeon should be prepared. |
| doi_str_mv | 10.2147/CIA.S69920 |
| format | Article |
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A retrospective case notes review of treated patients over the past 10 years in one tertiary center constituted our methodology.
The fistulas in two cases were successfully coiled with complete obviation of symptoms and signs. The third case was complicated due to difficulty in canulating a deeply seated vein and so had to be abandoned and catheterized through contralateral superior petrosal sinus and treated with liquid embolic material Onyx(®) successfully.
In cases where conventional access to the cavernous sinus may not be possible due to local variations of anatomy, multidisciplinary surgical approaches via the SOV provide an alternative route to successfully and safely close a CCF. However, unexpected anatomical variations could also be encountered within the SOV for which the surgeon should be prepared.</description><identifier>ISSN: 1178-1998</identifier><identifier>ISSN: 1176-9092</identifier><identifier>EISSN: 1178-1998</identifier><identifier>DOI: 10.2147/CIA.S69920</identifier><identifier>PMID: 25336933</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Aged ; Aged, 80 and over ; Care and treatment ; Carotid arteries ; Carotid-Cavernous Sinus Fistula - diagnostic imaging ; Carotid-Cavernous Sinus Fistula - therapy ; Catheters ; Cerebral Angiography ; Embolization, Therapeutic - methods ; Eye - blood supply ; Female ; Fistula ; Follow-Up Studies ; Health aspects ; Humans ; Intubation ; Medical imaging ; Methods ; Middle Aged ; Original Research ; Retrospective Studies ; Sinuses ; superior ophthalmic vein ; Surgery ; Thrombosis ; treatment ; Veins & arteries ; Venous Cutdown - methods</subject><ispartof>Clinical interventions in aging, 2014-01, Vol.9, p.1687-1690</ispartof><rights>COPYRIGHT 2014 Dove Medical Press Limited</rights><rights>2014. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 El-Hindy et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-5c36e7970b15ce67f0ab609304599332cee339d2a5979e46bf88c936935cadb83</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199976/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199976/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,3862,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25336933$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>El-Hindy, Nabil</creatorcontrib><creatorcontrib>Kalantzis, George</creatorcontrib><creatorcontrib>Patankar, Tufail</creatorcontrib><creatorcontrib>Georgalas, Ilias</creatorcontrib><creatorcontrib>Jyothi, Sreedar</creatorcontrib><creatorcontrib>Goddard, Tony</creatorcontrib><creatorcontrib>Chang, Bernard</creatorcontrib><title>Difficult indirect carotid-cavernous fistulas--alternative techniques to gaining access for treatment</title><title>Clinical interventions in aging</title><addtitle>Clin Interv Aging</addtitle><description>Carotid-cavernous fistulas (CCFs) are abnormal communications between the carotid arterial system and the cavernous sinus that occur mainly in elderly. Occasionally, treatment of indirect CCFs with conventional endovascular approach through large veins or the inferior petrosal sinus may not be possible. In these cases, a direct surgical cut down on to the superior ophthalmic vein (SOV) is necessary. We describe three such cases of embolization of CCFs through SOV, and their results.
A retrospective case notes review of treated patients over the past 10 years in one tertiary center constituted our methodology.
The fistulas in two cases were successfully coiled with complete obviation of symptoms and signs. The third case was complicated due to difficulty in canulating a deeply seated vein and so had to be abandoned and catheterized through contralateral superior petrosal sinus and treated with liquid embolic material Onyx(®) successfully.
In cases where conventional access to the cavernous sinus may not be possible due to local variations of anatomy, multidisciplinary surgical approaches via the SOV provide an alternative route to successfully and safely close a CCF. However, unexpected anatomical variations could also be encountered within the SOV for which the surgeon should be prepared.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Care and treatment</subject><subject>Carotid arteries</subject><subject>Carotid-Cavernous Sinus Fistula - diagnostic imaging</subject><subject>Carotid-Cavernous Sinus Fistula - therapy</subject><subject>Catheters</subject><subject>Cerebral Angiography</subject><subject>Embolization, Therapeutic - methods</subject><subject>Eye - blood supply</subject><subject>Female</subject><subject>Fistula</subject><subject>Follow-Up Studies</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Intubation</subject><subject>Medical imaging</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Original Research</subject><subject>Retrospective Studies</subject><subject>Sinuses</subject><subject>superior ophthalmic vein</subject><subject>Surgery</subject><subject>Thrombosis</subject><subject>treatment</subject><subject>Veins & arteries</subject><subject>Venous Cutdown - methods</subject><issn>1178-1998</issn><issn>1176-9092</issn><issn>1178-1998</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkl2L1DAUhoso7rp64w-QgiAidEyar-ZGGMavhQUv1OuQpqczWdJkTNIB_70ps-7OiOQi4eR53yRvTlW9xGjVYireb67Xq-9cyhY9qi4xFl2Dpewen6wvqmcp3SLEuGDt0-qiZYRwSchlBR_tOFozu1xbP9gIJtdGx5Dt0Bh9gOjDnOrRpjw7nZpGu1xqOtsD1BnMzttfM6Q6h3qrrbd-W2tjIBVJiHWOoPMEPj-vnozaJXhxN19VPz9_-rH52tx8-3K9Wd80hiGZG2YIByEF6jEzwMWIdM-RJIgyWW7bGgBC5NBqJoUEyvux64xcXsKMHvqOXFUfjr77uZ9gMOXoqJ3aRzvp-FsFbdX5jrc7tQ0HRUtKUvBigI4GQzjAPpaHnIkfqiZMCnecyiJ5e3dmDEsWWU02GXBOeyjZKcwxE7RllBb09T_obZhLmi6ptm1pMeOCPFBb7UBZP4ZyVbOYqjVFiGLKyUKt_kOVMcBkTfAw2lI_E7w5Eeyg_OQuBTdnG3w6B98dQRNDShHG-wgwUkvDqdJw6thwBX51mvg9-rfDyB9icdEH</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>El-Hindy, Nabil</creator><creator>Kalantzis, George</creator><creator>Patankar, Tufail</creator><creator>Georgalas, Ilias</creator><creator>Jyothi, Sreedar</creator><creator>Goddard, Tony</creator><creator>Chang, Bernard</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove Press</general><general>Dove Medical Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7XB</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>KB0</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140101</creationdate><title>Difficult indirect carotid-cavernous fistulas--alternative techniques to gaining access for treatment</title><author>El-Hindy, Nabil ; Kalantzis, George ; Patankar, Tufail ; Georgalas, Ilias ; Jyothi, Sreedar ; Goddard, Tony ; Chang, Bernard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-5c36e7970b15ce67f0ab609304599332cee339d2a5979e46bf88c936935cadb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Care and treatment</topic><topic>Carotid arteries</topic><topic>Carotid-Cavernous Sinus Fistula - diagnostic imaging</topic><topic>Carotid-Cavernous Sinus Fistula - therapy</topic><topic>Catheters</topic><topic>Cerebral Angiography</topic><topic>Embolization, Therapeutic - methods</topic><topic>Eye - blood supply</topic><topic>Female</topic><topic>Fistula</topic><topic>Follow-Up Studies</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Intubation</topic><topic>Medical imaging</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Original Research</topic><topic>Retrospective Studies</topic><topic>Sinuses</topic><topic>superior ophthalmic vein</topic><topic>Surgery</topic><topic>Thrombosis</topic><topic>treatment</topic><topic>Veins & arteries</topic><topic>Venous Cutdown - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>El-Hindy, Nabil</creatorcontrib><creatorcontrib>Kalantzis, George</creatorcontrib><creatorcontrib>Patankar, Tufail</creatorcontrib><creatorcontrib>Georgalas, Ilias</creatorcontrib><creatorcontrib>Jyothi, Sreedar</creatorcontrib><creatorcontrib>Goddard, Tony</creatorcontrib><creatorcontrib>Chang, Bernard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical interventions in aging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>El-Hindy, Nabil</au><au>Kalantzis, George</au><au>Patankar, Tufail</au><au>Georgalas, Ilias</au><au>Jyothi, Sreedar</au><au>Goddard, Tony</au><au>Chang, Bernard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Difficult indirect carotid-cavernous fistulas--alternative techniques to gaining access for treatment</atitle><jtitle>Clinical interventions in aging</jtitle><addtitle>Clin Interv Aging</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>9</volume><spage>1687</spage><epage>1690</epage><pages>1687-1690</pages><issn>1178-1998</issn><issn>1176-9092</issn><eissn>1178-1998</eissn><abstract>Carotid-cavernous fistulas (CCFs) are abnormal communications between the carotid arterial system and the cavernous sinus that occur mainly in elderly. Occasionally, treatment of indirect CCFs with conventional endovascular approach through large veins or the inferior petrosal sinus may not be possible. In these cases, a direct surgical cut down on to the superior ophthalmic vein (SOV) is necessary. We describe three such cases of embolization of CCFs through SOV, and their results.
A retrospective case notes review of treated patients over the past 10 years in one tertiary center constituted our methodology.
The fistulas in two cases were successfully coiled with complete obviation of symptoms and signs. The third case was complicated due to difficulty in canulating a deeply seated vein and so had to be abandoned and catheterized through contralateral superior petrosal sinus and treated with liquid embolic material Onyx(®) successfully.
In cases where conventional access to the cavernous sinus may not be possible due to local variations of anatomy, multidisciplinary surgical approaches via the SOV provide an alternative route to successfully and safely close a CCF. However, unexpected anatomical variations could also be encountered within the SOV for which the surgeon should be prepared.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>25336933</pmid><doi>10.2147/CIA.S69920</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1178-1998 |
| ispartof | Clinical interventions in aging, 2014-01, Vol.9, p.1687-1690 |
| issn | 1178-1998 1176-9092 1178-1998 |
| language | eng |
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| source | Taylor & Francis Open Access; MEDLINE; DOVE Medical Press Journals; DOAJ Directory of Open Access Journals; PubMed Central Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Aged, 80 and over Care and treatment Carotid arteries Carotid-Cavernous Sinus Fistula - diagnostic imaging Carotid-Cavernous Sinus Fistula - therapy Catheters Cerebral Angiography Embolization, Therapeutic - methods Eye - blood supply Female Fistula Follow-Up Studies Health aspects Humans Intubation Medical imaging Methods Middle Aged Original Research Retrospective Studies Sinuses superior ophthalmic vein Surgery Thrombosis treatment Veins & arteries Venous Cutdown - methods |
| title | Difficult indirect carotid-cavernous fistulas--alternative techniques to gaining access for treatment |
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