Endovascular treatment of carotid-cavernous vascular lesions

Abstract

Objective: to evaluate the endovascular treatment of vascular lesions of the cavernous segment of the internal carotidartery (ICA) performed at our institution. Methods: we conducted a descriptive, retrospective and prospective study of patients with aneurysms of the cavernous portion of the ICA or with direct carotid-cavernous fistulas (dCCF) undergoing endovascular treatment. Results: we included 26 patients with intracavernous aneurysms and ten with dCCF. All aneurysms were treated with ICA occlusion. Those with dCCF were treated with occlusion in seven cases and with selective fistula occlusion in the remaining three. There was improvement of pain and ocular proptosis in all patients with dCCF. In patients with intracavernous aneurysms, the incidence of retro-orbital pain fell from 84.6% to 30.8% after treatment. The endovascular treatment decreased the dysfunction of affected cranial nerves in both groups, especially the oculomotor one. Conclusion: the endovascular treatment significantly improved the symptoms in the patients studied, especially those related to pain and oculomotor nerve dysfunction.

Caso clínico: Fístula Carótido Cavernosa

“…Como se citó anteriormente, el paciente fue tratado de manera clínica para el control de la presión intraocular seguido de tratamiento endovascular con embolización transvenosa como en el caso de la investigación de la revista brasileña de Colegio de Cirujanos, febrero 2017, en el que realizó un estudio retrospectivo se concluyó que tras un diagnóstico precoz, el tratamiento endovascular obtuvo mejores resultados, y se asocia a una menor tasa de morbimortalidad en pacientes con esta patología. 12 La Fístula Carótido-Cavernosa forma parte de las afecciones neuro-oftálmicas poco frecuentes de tipo espontáneo, pero con una alta incidencia relacionada con traumatismos craneoencefálicos. Dichas fístulas ocurren por varios factores desencadenantes y complicaciones posttraumáticas o espontáneas.…”

Cefaléia e disfunção de nervos cranianos secundários a aneurisma de artéria carótida: relato de dois casos e revisão da literatura

“…Nevertheless, they highlighted the absence of long-term outcomes studies in this field. In a single-institution series, Aguiar et al 21 conducted a descriptive, retrospective, and prospective study of patients with aneurysms of the cavernous portion of the ICA or with direct carotid-cavernous fistulas undergoing endovascular treatment. The authors evaluated 26 patients with CCA treated with ICA occlusion.…”