Ouyang G, Zheng KL, Luo K, Qiao M, Zhu Y, Pan DR. Endovascular treatment of direct carotid cavernous fistula resulting from rupture of intracavernous carotid aneurysm: A case report. World J Clin Cases 2024; 12(11): 1940-1946 [PMID: 38660547 DOI: 10.12998/wjcc.v12.i11.1940]
Corresponding Author of This Article
De-Rui Pan, MD, Doctor, Department of Neurosurgery, Puren Hospital Affiliated to Wuhan University of Science and Technology, No. 1 Benxi Street, Qingshan District, Wuhan 430081, Hubei Province, China. 15707252133@163.com
Research Domain of This Article
Clinical Neurology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2024; 12(11): 1940-1946 Published online Apr 16, 2024. doi: 10.12998/wjcc.v12.i11.1940
Endovascular treatment of direct carotid cavernous fistula resulting from rupture of intracavernous carotid aneurysm: A case report
Guang Ouyang, Kai-Li Zheng, Kuan Luo, Mu Qiao, Yuan Zhu, De-Rui Pan
Guang Ouyang, Kai-Li Zheng, Kuan Luo, Mu Qiao, De-Rui Pan, Department of Neurosurgery, Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430081, Hubei Province, China
Yuan Zhu, Department of Neurosurgery, The Third Hospital of Wuhan, Wuhan 430081, Hubei Province, China
Author contributions: Ouyang G and Zheng K were responsible for manuscript writing and data curation; Luo K and Qiao M were responsible for data curation; Zhu Y was responsible for methodology and resources; Pan D was responsible for manuscript writing, reviewing, and editing, and project administration.
Informed consent statement: Informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: De-Rui Pan, MD, Doctor, Department of Neurosurgery, Puren Hospital Affiliated to Wuhan University of Science and Technology, No. 1 Benxi Street, Qingshan District, Wuhan 430081, Hubei Province, China. 15707252133@163.com
Received: November 2, 2023 Peer-review started: November 2, 2023 First decision: December 7, 2023 Revised: January 2, 2024 Accepted: March 20, 2024 Article in press: March 20, 2024 Published online: April 16, 2024 Processing time: 160 Days and 17.6 Hours
Abstract
BACKGROUND
Direct carotid cavernous fistulas (CCFs) are typically the result of a severe traumatic brain injury. High-flow arteriovenous shunts secondary to rupture of an intracavernous aneurysm, resulting in direct CCFs, are rare. The use of a pipeline embolization device in conjunction with coils and Onyx glue for treatment of direct high-flow CCF resulting from ruptured cavernous carotid artery aneurysm in a clinical setting is not well documented.
CASE SUMMARY
A 58-year-old woman presented to our department with symptoms of blepharoptosis and intracranial bruits for 1 wk. During physical examination, there was right eye exophthalmos and ocular motor palsy. The rest of the neurological examination was clear. Notably, the patient had no history of head injury. The patient was treated with a pipeline embolization device in the ipsilateral internal carotid artery across the fistula. Coils and Onyx were placed through the femoral venous route, followed by placement of the pipeline embolization device with assistance from a balloon-coiling technique. No intraoperative or perioperative complications occurred. Preoperative symptoms of bulbar hyperemia and bruits subsided immediately after the operation.
CONCLUSION
Pipeline embolization device in conjunction with coiling and Onyx may be a safe and effective approach for direct CCFs.
Core Tip: A patient with direct carotid cavernous fistula was treated with a pipeline embolization device in the ipsilateral internal carotid artery across the fistula. Additionally, coils and Onyx were placed through the femoral venous route, followed by placement of the pipeline embolization device with assistance from a balloon-coiling technique. No intraoperative or perioperative complications occurred. Preoperative symptoms of bulbar hyperemia and bruits subsided immediately after the operation.
