Spontaneous Occlusion of a bilateral caroticocavernous fistula studied by serial angiography

Voigt, Karsten; Sauer, M.; Dichgans, J.

doi:10.1007/bf00337568

Cited by 81 publications

(34 citation statements)

References 18 publications

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“…Some isolated case series have hinted that some of these patients may undergo an angiographic pattern conversion on long-term follow-up. 3,[12][13][14][15][16][17][18][19][20][21][22] However, many of these patients had been treated palliatively and there is still controversy on whether or how often these lesions may actually show an evolutive pattern conversion without any treatment alterations. 23,24 The purpose of this study is to define the incidence, clinical, and angioarchitectural characteristics of patients with cranial DAVS showing natural temporal pattern conversions on diagnostic subtraction angiography (DSA) based on the long-term follow-up data from a large single-center database.…”

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confidence: 99%

Spontaneous Angiographic Conversion of Intracranial Dural Arteriovenous Shunt

Kim

terBrugge

Krings

et al. 2010

Stroke

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Background and Purpose-Dural arteriovenous shunt (DAVS) is a disease in which abnormal arteriovenous communications develop within the dura. Some case series have suggested DAVS may evolve over time, but the natural history is poorly understood. In this study, we aimed to define the incidence and clinical characteristics of patients with DAVS showing spontaneous angiographic pattern conversion. Methods-We assessed clinical and angiographic features of patients with angiographic conversion without any treatment from a single center database consisting of 335 DAVS cases. Spontaneous angiographic conversion was defined as complete occlusion of a pre-existing DAVS or conversion of a benign into an aggressive lesion on follow-up diagnostic subtraction angiography. Results-One hundred twelve patients were followed without treatment after the initial diagnosis of DAVS. Overall, we saw pattern conversion on angiography in 18 of the 112 cases (16.1%). Fourteen patients showed spontaneous occlusion of the shunt (12.5%); the most common locations of spontaneous obliteration were the transverse and cavernous sinuses. Four patients showed conversion to an aggressive lesion from benign DAVS (4.0%); all of these cases were associated with occlusion of the ipsilateral draining vein. Conclusions-DAVS is a dynamic disorder, which will show chronological progression. Spontaneous angiographic obliteration or conversion into an aggressive type may occur on follow-up of untreated DAVSs. (Stroke.

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confidence: 99%

Spontaneous Angiographic Conversion of Intracranial Dural Arteriovenous Shunt

Kim

terBrugge

Krings

et al. 2010

Stroke

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“…Spontaneous CCF are less commonly visu alized as a direct shunt of internal CCF. According to the review of Voigt,24) in the development of spontaneous direct shunts, several factors were implicated: intracavernous rupture of persistent embryonal vascular chan nels such as the primitive ophthalmic or trigeminal artery and intracavernous aneurysms of the internal carotid artery, or tearing of the sclerotic walls of the internal carotid artery. Also, pregnancy or infectious diseases have been accepted as etiological factors."…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Carotid-Cavernous Fistulas

Bitoh

Hasegawa

Fujiwara

et al. 1981

Neurol. Med. Chir.(Tokyo)

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SummarySeven patients with spontaneous carotid-cavernous fistulas are reported. Angiography showed a direct shunt between the internal carotid artery and the cavernous sinus in twc patients (Cases 2 and 6) and dural arteriovenous shunts in the cavernous sinus region in five patients (Cases 1, 3, 4, 5 and 7). They were treated by ligation of the external carotid artery (Cases 1 and 3), occlusion of the common carotid artery (Case 6), embolization of the fistula (Case 2), embolization and ligation of the external carotid artery and excision of the dural lesion (Case 5), embolization and ligation of the external carotid artery (Case 7), or irradiation (Case 4). Post-treatment angiography showed complete closure of the fistulas in four patients (Cases 1, 2, 4 and 7). In two patients (Cases 3 and 5), small angiomatous lesions were noted, one which regressed spontaneously one year postop eratively and one which improved clinically. We suggest that in surgically inaccessible shunts, irradiation may be a viable alternative treatment.

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“…Type A traumatic CCF rarely resolves spontaneously, about 3%, however, dural forms of CCF tends to resolve spontaneouly more about 30% 5,7,8,10,11,17,27) . The spontaneous thrombosis of traumatic CCF with pseudoaneurysm formation were rarely reported 15,20,21,[23][24][25][26][27][28][29][30][31] . Nishijima et al reported 5…”

Section: Case Reportmentioning

confidence: 99%

“…Three of the five cases developed the false aneurysm after spontaneous occlusion of CCF and no further detail about the fate of false aneurysms was described. Most of the case reports of spontaneous occlusion of CCF were done by direct percutaneous carotid angiography or open carotid angiography under general anesthesia in the past 15,24,26,30,31) . However, spontaneous obliteration of CCF after TFCA was also reported rarely since first time on 1981 by Shields et al 20,23,27) .…”

Section: Case Reportmentioning

confidence: 99%

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Spontaneous Occlusion of Traumatic Carotid Cavernous Fistula with Pseudoaneurysm Formation-management with Neuroform Stent and Coiling: A Case Report

Cho

Kim

et al. 2006

J Korean Neurotraumatol Soc

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We experienced a case of traumatic carotid cavernous fistula (CCF) which was occluded spontaneously within 7 days after transfemoral carotid angiography with complete disapperance of symtoms. Traumatic CCF is almost always type A and known to rarely resolves spontaneously. The suggested mechanism of spontaneous occlusion were manual compression of carotid artery, hypotension during percutaneous or open direct carotid angiography under general anesthesia in the past as well as thrombogenicity of iodinated contrast media and catheterization procedure itself are more related with recent transfemoral carotid angiography. The pseudoaneurysm managed with coil or balloon should be frequently followed up due to compaction by the surrounding thrombus.

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Spontaneous Occlusion of a bilateral caroticocavernous fistula studied by serial angiography

Cited by 81 publications

References 18 publications

Spontaneous Angiographic Conversion of Intracranial Dural Arteriovenous Shunt

Spontaneous Angiographic Conversion of Intracranial Dural Arteriovenous Shunt

Spontaneous Carotid-Cavernous Fistulas

Spontaneous Occlusion of Traumatic Carotid Cavernous Fistula with Pseudoaneurysm Formation-management with Neuroform Stent and Coiling: A Case Report

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