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  • Title: [Refractory carotid-cavernous fistula: causes and countermeasures].
    Author: Wang D, Ling F, Li M, Zhang H, Miu Z, Song Q, Li X, Hao M.
    Journal: Zhonghua Wai Ke Za Zhi; 1999 Dec; 37(12):754-6. PubMed ID: 11829946.
    Abstract:
    OBJECTIVE: To explore the causes and countermeasures of refractory carotid-cavernous fistula (CCF). METHODS: Twelve refractory cases from 123 cases of consecutive traumatic CCF during 12 years were reviewed. RESULTS: The main causes of refractory CCF were: small or large fistula's opening, or constrictive parent artery; inappropriate early treatments such as ligature of internal carotid artery or common carotid artery, balloon detachment of, and non-dense packing of coils inside the cavernous sinus; unexpected deflation or balloon displacement of resulting in fistula recurrence. Anatomical cure was achieved in 11 cases, and clinical care in 1 by using balloon or/and coil or/and NBCA (n-butal 2-cyanoacrylate) through arterial, venous or surgical approach. CONCLUSIONS: refractory CCF can be treated effectively skilled catheterization and embolization as well as appropriate approach and embolic material according to fistula structure and vascular route.
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