Abstract
Carotid cavernous fistulas (CCF) are complex lesions involving the abnormal shunting of arterial blood into the cavernous sinus. There are two distinct types: one is a direct communication between the internal carotid artery and the cavernous sinus, while the other is a dural shunt involving meningeal branches of the external and/or internal carotid arteries. Resulting patient symptoms as well as potential complications is determined primarily by the degree of arteriovenous shunting as well as the direction of venous outflow from the cavernous sinus. Catheter angiography remains the gold standard imaging evaluation of CCFs, although both MR and CT angiography can be used to screen patients in whom the diagnosis is suspected. Current treatment for these lesions consists primarily of conservative management and endovascular embolization. The latter can be performed via transarterial and/or transvenous approaches, using various materials such as detachable balloons, coils, and liquid embolic agents. A multidisciplinary approach, including neurointerventionalists, neurosurgeons, and ophthalmologists, is often required to achieve the best outcomes for patients.
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Miller, T.R., Shivashankar, R., Jindal, G., Gandhi, D. (2014). Carotid Cavernous Fistula. In: Saba, L., Raz, E. (eds) Neurovascular Imaging. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9212-2_7-1
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DOI: https://doi.org/10.1007/978-1-4614-9212-2_7-1
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