Speciality Endovascular Techniques
Library of the School of Health Sciences

2019-06-14

2019

Stefanidis Petros

Γεώργιος Γερουλάκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ιωάννης Κακίσης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αχιλλέας Χατζηϊωάννου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Ενδαγγειακή αντιμετώπιση καρωτιδοσηραγγώδους επικοινωνίας

English

Endovascular treatment of carotid-cavernous fistulas

INTRODUCTION: Carotid cavernous fistulas are abnormal communications between the cavernous sinus and the cavernous segment of the internal carotid artery or between the cavernous sinus and braches of the external carotid. An anatomical classification proposed by Barrow divides the carotid cavernous fistulas into four types. The goal of the treatment is to occlude the arteriovenous shunt. The open surgical procedures include cavernous sinus exploration, ligation of the arterial part of the shunt and trapping. The advances in endovascular techniques have resulted new, more safe and effective methods of treatment. New materials in combination with new endovascular strategies have provided safer and easier treatment of the carotid cavernous fistulas. The endovascular treatment has become the primary treatment for these fistulas and has totally replaced the open surgery due to smaller percentage of mortality and morbidity.
PURPOSE: The aim of this study is to report the treatment results, the complications and the recurrence rate of patients that suffered from carotid cavernous fistulas and underwent endovascular procedures. These results will show the efficiency of the endovascular treatment in these lesions.
MATERIALS AND METHODS: In association with the Department Of Interventional Neuroradiology and Neurosurgery Of “YGEIA” Hospital, 25 patients with carotid cavernous fistulas were treated using endovascular techniques. 13 of these patients had direct fistulas (Type A) and the rest had indirect fistulas (Type B, C, D). The technical details of the procedures followed the general principles of endovascular treatment and were based on the experience of the operator. Eleven patients were treated though the arterial pathway and fourteen through the venous pathway. Various embolic material were used such us coils, onyx, glue, and stents. All the operations were carried out under general anesthesia. The results will be analyzed with the help of SPSS statistic program. The analysis of the post operation results and the comparison with the results of other endovascular centers will provide us information about the safety and the efficiency of the endovascular treatment of the carotid cavernous fistulas, will give us useful information about the techniques and the strategies of endovascular treatment and will demonstrate the superiority of the endovascular method. This superiority has established the endovascular treatment as the gold standard method of treatment of these lesions.

Health Sciences

Carotid-cavernous fistula

No

0

Yes

53

43

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https://pergamos.lib.uoa.gr/uoa/dl/object/2876130