Spontaneous carotid-cavernous fistulas: clinical, radiological, and therapeutic considerations

Viñuela, Fernando; Fox, Allan J.; Debrun, Gérard; Peerless, Sydney J.; Drake, Charles G.

doi:10.3171/jns.1984.60.5.0976

Cited by 221 publications

(115 citation statements)

References 19 publications

(5 reference statements)

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…10,12,42,81 Ruptured cavernous ICA aneurysms are an often-cited cause of spontaneous, direct CCFs. Cavernous-carotid fistulas are reported in anywhere from 3% to 24% of patients with cavernous carotid aneurysms.…”

Section: Spontaneous Ccfsmentioning

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

Section: Spontaneous Ccfsmentioning

confidence: 99%

Carotid-cavernous fistulas

Ellis¹,

Goldstein²,

Connolly³

et al. 2012

FOC

276

326

View full text Add to dashboard Cite

show abstract

“…15,40 However, some cases present with intractable intraocular hypertension or reduced ocular perfusion pressure, thereby warranting more rapid interventions to prevent progressive vision loss. 36,40,49 Due to their unique anatomy and symptomatology, CS DAVFs are often categorized using the Barrow classification system. 4 Type A fistulas represent direct high-flow shunts between the internal carotid artery and the CS, comprising mostly traumatic fistulas formed as a result of a tear in the cavernous segment of the internal carotid artery.…”

Section: Comparison Of Cs Davfs and Ncs Davfsmentioning

confidence: 99%

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Chen¹,

Lee

Ding³

et al. 2015

JNS

View full text Add to dashboard Cite

C urrent treatment strategies for intracranial dural arteriovenous fistulas (DAVFs) include microsurgical ligation, transarterial or transvenous embolization, stereotactic radiosurgery (SRS), and various combinations of these therapeutic options. Endovascular therapy, most commonly performed via transvenous routes, has become the preferred treatment approach for DAVFs. 27,44,48 Due to the immediate obliteration that can be achieved with endovascular or surgical occlusion, SRS is typically reserved for lesions that cannot be obliterated with endovascular or surgical approaches, or for patients who pose a high surgical risk due to medical comorbidities. Therefore, published SRS series for DAVFs remain relatively few and comprise mostly retrospective, single-center studies.In this systematic review, we evaluate the obliteration rate of DAVFs in patients treated with SRS. We also compare obliteration rates between cavernous sinus (CS) and noncavernous sinus (NCS) DAVFs, and between DAVFs with and without cortical venous drainage (CVD), by using available data in the literature. Methods inclusion CriteriaIn our attempt to balance between the largest possible patient population and a relatively homogeneous cohort, the following inclusion criteria for this systematic review were devised: 1) the study must contain at least 5 patients abbreviatioNs AVM = arteriovenous malformation; CS = cavernous sinus; CVD = cortical venous drainage; DAVF = dural arteriovenous fistula; GKS = Gamma Knife surgery; LINAC = linear accelerator; NCS = noncavernous sinus; SRS = stereotactic radiosurgery; TSS = transverse and sigmoid sinus. obJeCt The goal of this study was to evaluate the obliteration rate of intracranial dural arteriovenous fistulas (DAVFs) in patients treated with stereotactic radiosurgery (SRS), and to compare obliteration rates between cavernous sinus (CS) and noncavernous sinus (NCS) DAVFs, and between DAVFs with and without cortical venous drainage (CVD). Methods A systematic literature review was performed using PubMed. The CS DAVFs and the NCS DAVFs were categorized using the Barrow and Borden classification systems, respectively. The DAVFs were also categorized by location and by the presence of CVD. Statistical analyses of pooled data were conducted to assess complete obliteration rates in CS and NCS DAVFs, and in DAVFs with and without CVD. results Nineteen studies were included, comprising 729 patients harboring 743 DAVFs treated with SRS. The mean obliteration rate was 63% (95% CI 52.4%-73.6%). Complete obliteration for CS and NCS DAVFs was achieved in 73% and 58% of patients, respectively. No significant difference in obliteration rates between CS and NCS DAVFs was found (OR 1.72, 95% CI 0.66-4.46; p = 0.27). Complete obliteration in DAVFs with and without CVD was observed in 56% and 75% of patients, respectively. A significantly higher obliteration rate was observed in DAVFs without CVD compared with DAVFs with CVD (OR 2.37, 95% CI 1.07-5.28; p = 0.03). CoNClusioNs Treatment with SRS offers favorable rates of D...

show abstract

“…Notably, Jacobson and colleagues conclude that the recognition of traumatic origin allow an adequate choice of route and material to be used, we do not think that the traumatic history is a planning guide for management, we believe the choice of route and the material will be governed by the amount and type of tributaries that have the fistula, and venous drainage pattern, considerations that go far beyond agreement cited by other authors (6,7,10,12).…”

Section: Etiologymentioning

confidence: 85%

Endovascular management of dural fistulas into the cavernous sinus. A systematic review

Moscote-Salazar¹,

Zenteno²,

Santos-Franco³

et al. 2014

Romanian Neurosurgery

View full text Add to dashboard Cite

Background: Dural fistula to the cavernous sinus (DFCS) is an infrequent pathology that consists in the anomalous communication between the meningeal branches of the internal carotid artery (ICA) and/or the external carotid artery (ECA) and the cavernous sinus.Aim: To perform a systematic review to evaluate clinical and imaging findings in DFCS, and current indications for treatment.Methods: A literature search was performed in several medical databases using the keywords "intracranial dural fistula", "carotid-cavernous fistula", "endovascular treatment", associated with "outcome"; resulting articles were assessed by considering factors such as: number of patients treated, type of material used, complications, and type of image technique used for diagnosis.Results: 33 articles were selected, yielding: clinical and imaging: The symptoms are basically related to the type of venous drainage

show abstract

Spontaneous carotid-cavernous fistulas: clinical, radiological, and therapeutic considerations

Cited by 221 publications

References 19 publications

Carotid-cavernous fistulas

Carotid-cavernous fistulas

Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

Endovascular management of dural fistulas into the cavernous sinus. A systematic review

Contact Info

Product

Resources

About