Iatrogenic Carotid Cavernous Fistula

Takahashi, Masashi; Killeffer, Fred A.; Wilson, George E.

doi:10.3171/jns.1969.30.4.0498

Cited by 33 publications

(11 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Traumatic CCFs may develop at the time of the injury or form days to weeks after injury. Iatrogenic, "traumatic" CCFs have been reported following carotid endarterectomy, endovascular procedures, trannssphenoidal pituitary surgery, otolaryngologic surgery, and in procedures directed at the trigeminal ganglion for the treatment of neuralgia [4][5][6][7].…”

Section: Direct Carotid Cavernous Sinus Fistulasmentioning

confidence: 99%

Cavernous sinus fistulas: Carotid cavernous fistulas and dural arteriovenous malformations

Feiner

Bennett

Volpe

2003

Curr Neurol Neurosci Rep

View full text Add to dashboard Cite

Direct and indirect carotid cavernous sinus fistulas are uncommon vascular anomalies that result in increased pressure in the cavernous sinus. The subsequent changes in blood flow lead to orbital venous congestion, cranial neuropathies, and glaucoma. The following review summarizes knowledge of the clinical features, natural history, diagnostic testing, and therapy for carotid cavernous sinus fistulas.

show abstract

Section: Direct Carotid Cavernous Sinus Fistulasmentioning

confidence: 99%

Cavernous sinus fistulas: Carotid cavernous fistulas and dural arteriovenous malformations

Feiner

Bennett

Volpe

2003

Curr Neurol Neurosci Rep

View full text Add to dashboard Cite

show abstract

“…Although rare, there have also been reports of CCFs caused by iatrogenic injury during craniotomy, carotid endarterectomy, transsphenoidal exploration, endovascular procedures, and sinus surgery. 40,50,59,63,70,74 Bilateral CCFs are seen in 1%-2% of patients with posttraumatic CCFs.…”

Section: 46mentioning

confidence: 99%

Carotid-cavernous fistulas

Ellis¹,

Goldstein²,

Connolly³

et al. 2012

FOC

276

326

View full text Add to dashboard Cite

Carotid-cavernous fistulas (CCFs) are vascular shunts allowing blood to flow from the carotid artery into the cavernous sinus. The characteristic clinical features seen in patients with CCFs are the sequelae of hemodynamic dysfunction within the cavernous sinus. Once routinely treated with open surgical procedures, including carotid ligation or trapping and cavernous sinus exploration, endovascular therapy is now the treatment modality of choice in many cases. The authors provide a review of CCFs, detailing the current classification and clinical management of these lesions. Therapeutic options including conservative management, open surgery, endovascular intervention, and radiosurgical therapy are presented. The complications and treatment results as reported in the contemporary literature are also reviewed.

show abstract

“…The endoscopic understanding of the ICA is important because of the increased use of endoscopic approaches to the base of the skull that may cause ICA injury or pseudoaneurysm after ventral endoscopic approaches. [2569101317181920212223242526272829] The numerical classification systems may be confusing because of changes in the numerical systems based on updated findings. In proposing the present classification system, we added information about associated structures to each segment, based on detailed statistical analysis, which may be valuable in alerting the surgeon about structures at risk, depending on the surgical zone, during lateral microsurgical or ventral endoscopic procedures [Table 3].…”

Section: Discussionmentioning

confidence: 99%

Proposed clinical internal carotid artery classification system

Abdulrauf

Ashour

Marvin

et al. 2016

J Craniovert Jun Spine

View full text Add to dashboard Cite

Introduction:Numerical classification systems for the internal carotid artery (ICA) are available, but modifications have added confusion to the numerical systems. Furthermore, previous classifications may not be applicable uniformly to microsurgical and endoscopic procedures. The purpose of this study was to develop a clinically useful classification system.Materials and Methods:We performed cadaver dissections of the ICA in 5 heads (10 sides) and evaluated 648 internal carotid arteries with computed tomography angiography. We identified specific anatomic landmarks to define the beginning and end of each ICA segment.Results:The ICA was classified into eight segments based on the cadaver and imaging findings: (1) Cervical segment; (2) cochlear segment (ascending segment of the ICA in the temporal bone) (relation of the start of this segment to the base of the styloid process: Above, 425 sides [80%]; below, 2 sides [0.4%]; at same level, 107 sides [20%]; P < 0.0001) (relation of cochlea to ICA: Posterior, 501 sides [85%]; posteromedial, 84 sides [14%]; P < 0.0001); (3) petrous segment (horizontal segment of ICA in the temporal bone) starting at the crossing of the eustachian tube superolateral to the ICA turn in all 10 samples; (4) Gasserian-Clival segment (ascending segment of ICA in the cavernous sinus) starting at the petrolingual ligament (PLL) (relation to vidian canal on imaging: At same level, 360 sides [63%]; below, 154 sides [27%]; above, 53 sides [9%]; P < 0.0001); in this segment, the ICA projected medially toward the clivus in 275 sides (52%) or parallel to the clivus with no deviation in 256 sides (48%; P < 0.0001); (5) sellar segment (medial loop of ICA in the cavernous sinus) starting at the takeoff of the meningeal hypophyseal trunk (ICA was medial into the sella in 271 cases [46%], lateral without touching the sella in 127 cases [23%], and abutting the sella in 182 cases [31%]; P < 0.0001); (6) sphenoid segment (lateral loop of ICA within the cavernous sinus) starting at the crossing of the fourth cranial nerve on the lateral aspect of the cavernous ICA and located directly lateral to the sphenoid sinus; (7) ring segment (ICA between the 2 dural rings) starting at the crossing of the third cranial nerve on the lateral aspect of the ICA; (8) cisternal segment starting at the distal dural ring.Conclusions:The classification may be applied uniformly to all skull base surgical approaches including lateral microsurgical and ventral endoscopic approaches, obviating the need for 2 separate classification systems. The classification allows extrapolation of relevant clinical information because each named segment may indicate potential surgical risk to specific structures.

show abstract

Iatrogenic Carotid Cavernous Fistula

Cited by 33 publications

References 15 publications

Cavernous sinus fistulas: Carotid cavernous fistulas and dural arteriovenous malformations

Cavernous sinus fistulas: Carotid cavernous fistulas and dural arteriovenous malformations

Carotid-cavernous fistulas

Proposed clinical internal carotid artery classification system

Contact Info

Product

Resources

About