Caroticocavernous fistula management by detachable balloon at different clinical stages

ABSTRACT

The authors describe their first experience in transarterial balloon embolization in the treatment of CCF. Six patients presenting with traumatic CCF were included in the study during the period between 1990 and 1993. All had an established clinical diagnosis after thorough neurological and ophthalmological assessment together with positive radiological evidence through head computed tomography and cerebral angiography. They ranged in age between 15 and 55 years. All were males except one. They presented mainly with machinery bruit and exophthalmos. Proptosis was unilateral in five patients and bilateral in the remaining one. Favourable results were obtained. Post- embolization improvement, and even normalization, set-in in five of the six patients regarding bruit and proptosis without any resultant complications. Only in a single patient delayed balloon deflation and intracranial migration occurred with consequent major cerebral infarction and death. The authors conclude that transarterial balloon embolization remains the procedure of choice in the treatment of symptomatic CCF. However, transvenous embolization is an alternative when the arterial route fails