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Chapter-16 Carotid-Cavernous Fistulas

BOOK TITLE: Neurovascular Surgical Techniques

Author
1. Ashour Ramsey
2. Elhammady Mohamed Samy
3. Aziz-Sultan Mohammed Ali
ISBN
9789350900888
DOI
10.5005/jp/books/11824_16
Edition
1/e
Publishing Year
2013
Pages
13
Author Affiliations
1. Lois Pope Life Center-2nd Floor, 1095 NW 14th Terrace (D4-6), Miami, Florida, USA
2. Lois Pope Life Center-2nd Floor, 1095 NW 14th Terrace (D4-6), Miami, Florida, USA
3. University of Miami, Miller School of Medicine, Miami, Florida, USA
Chapter keywords
Carotid-cavernous fistula, arterio-venous shunt, internal carotid artery, external carotid artery, cavernous sinus, orbital venous congestion, intracerebral hemorrhage, cranial nerve palsies, endovascular embolization, microsurgical techniques

Abstract

A carotid-cavernous fistula (CCF) is an abnormal arterio-venous shunt connecting the internal carotid artery (ICA) and the external carotid artery (ECA) to the cavernous sinus. CCF commonly produce ophthalmologic symptoms related to orbital venous congestion. In addition they may also cause cranial nerve palsies, cerebral venous hypertension and cortical venous reflux associated with a high-risk of intracerebral hemorrhage. The CCF can be treated with endovascular interventions or surgery interventions. This chapter, gives an briefly review on the history and clinical features of CCFs and also describes the principles of their treatment through endovascular and open surgical techniques. Endovascular embolization is a safe and highly effective method for treating CCFs that continues to evolve as new embolic agents, catheters, stents and balloons become available for use. Direct surgery can be performed with reasonably low morbidity to effectively treat those CCFs that have failed endovascular therapy and still require treatment.

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