Türk Nöroşirürji Dergisi 2024 , Vol 34 , Num 3
Management of Carotid-Cavernous Fistulas and Case Series
Mehmet Orbay BIYIK1,Mehmet AKTOKLU1,Ali Rıza GÜVERCIN1,Uğur YAZAR1
1Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Trabzon, Türkiye DOI : 10.5137/1019-5157.TND.3314 AIM: Carotid-cavernous fistula (CCF) is an abnormal arteriovenous shunt between the internal carotid artery (ICA) and/or external carotid artery (ECA) or one of its branches and the cavernous sinus (CS). CCF will present acutely if it is the result of a traumatic event, but may also present insidiously in the case of indirect low flow and may be delayed in diagnosis and treatment. The classic triad is ocular murmur, chemosis, and proptosis. Digital substraction aniography (DSA) is the gold standard for diagnosis. The aim of our article on carotid-cavernous fistulae is to review these pathologies, whose follow-up and treatment can be complicated, and to contribute to the literature with a case series.

MATERIAL and METHODS: In this study, we retrospectively analyzed the data of patients who were followed up at our hospital between 2009 and 2023 due to CHF and underwent digital subtraction angiography (DSA).

RESULTS: In our case series, the mean age was 51 years, and 66% of the patients were female and 34% were male. Etiologically, 58% of the cases were spontaneous and 42% were traumatic. The most common symptoms were chemosis, ptosis, and orbital pain. Most of the patients with spontaneous CHF had chronic comorbidities such as hypertension and diabetes mellitus. Most of the patients were treated with endovascular methods, but recurrence was observed in some cases and re-treatment was performed. Balloon, liquid embolizing agent and coil embolizing materials were used during treatment. The best results were obtained in patients with coils and stents.

CONCLUSION: Endovascular methods are used as the first choice in the treatment of CHFs with high success rates. The data obtained in our study are consistent with the literature and support the effectiveness of endovascular treatment in the management of CHFs. Anahtar Kelimeler : Endovascular treatment, External Carotid Artery, Internal Carotid Artery, Cavernous sinus, Carotidocavernous fistula