Tratamiento de fístulas carótido-cavernosas

Fístula carotídeo-cavernosa

“…About 75% of cases have some permanent loss of visual acuity (44) . Different studies found 85-90% success rates, and complications range from 5 to 8% (death in 1%) (8,29,35) . Relapse is not uncommon (8) .…”

“…Direct fistulas can cause acute symptoms or manifest after days or months. They are usually 1-5 mm in size and 1-2% are bilateral, or even contralateral to the ophthalmic signs (8,29) . Indirect CCF, also called dural shunt, is typically a low-flow condition which may be congenital or occur spontaneously, and which causes or results from venous thrombosis.…”

“…The endovascular approach is the current procedure of choice, either through an arterial or venous access. Different natural or synthetic occlusive materials can be used: Absorbable gelatin (gelfoam), silastic, silicone, platinum coils, autologous blood or blood products, polyvinyl alcohol, ethanol, cyanoacrylate, concomitant radiosurgery (6,17,23,24,28,29,32,57,(64)(65)(66)(67)(68) . About 75% of cases have some permanent loss of visual acuity (44) .…”

“…This manoeuvre should be performed using the contralateral hand (thus any deficit in this arm acts as a warning and a safety mechanism to interrupt compression) for 10 seconds, 5-6 times every hour. Compression should be increased over a few weeks (29) . There are some contraindications to compression.…”