Transvenous Embolization of Carotid-Cavernous Sinus Fistula Associated with a Primitive Trigeminal Artery. Case Report.

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  • OKA Yoshihisa
    Department of Neurological Surgery, Washokai Sadamoto Hospital
  • SADAMOTO Kazuhiko
    Department of Neurological Surgery, Washokai Sadamoto Hospital
  • TAGAWA Masahiko
    Department of Neurological Surgery, Ehime University School of Medicine
  • KUMON Yoshiaki
    Department of Neurological Surgery, Ehime University School of Medicine
  • SAKAKI Saburo
    Department of Neurological Surgery, Ehime University School of Medicine
  • FUJITA Manabu
    Department of Neurological Surgery, Imabari Prefectural Hospital

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  • <b>—Case Report—</b>

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A 58-year-old female presented with right conjunctival chemosis and right abducens nerve paresis. Cerebral angiography demonstrated a right carotid-cavernous sinus fistula associated with persistent primitive trigeminal artery. The fistula was treated by introducing detachable coils through the transvenous approach, as the detachable balloon was not available. Follow-up angiography performed 14 days after the embolization revealed complete disappearance of the carotid-cavernous sinus fistula due to thrombosis, which was presumably accelerated by the coils. Transvenous coil embolization should be considered as an alternative treatment for high-flow carotid-cavernous sinus fistula, but only if transarterial balloon embolization is not successful or unavailable.

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