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Follow-Up of 58 Traumatic Carotid-Cavernous Fistulas after Endovascular Detachable-Balloon Embolization at a Single Center

BACKGROUND AND PURPOSE: This study evaluated the clinical value of detachable-balloon embolization for traumatic carotid-cavernous fistula (TCCF), focusing on the frequency, risk factors, and retreatment of recurrence. METHODS: Fifty-eight patients with TCCF underwent transarterial detachable-balloo...

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Detalles Bibliográficos
Autores principales: Xu, Xiao-Quan, Liu, Sheng, Zu, Qing-Quan, Zhao, Lin-Bo, Xia, Jin-Guo, Zhou, Chun-Gao, Zhou, Wei-Zhong, Shi, Hai-Bin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurological Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633195/
https://www.ncbi.nlm.nih.gov/pubmed/23626645
http://dx.doi.org/10.3988/jcn.2013.9.2.83
Descripción
Sumario:BACKGROUND AND PURPOSE: This study evaluated the clinical value of detachable-balloon embolization for traumatic carotid-cavernous fistula (TCCF), focusing on the frequency, risk factors, and retreatment of recurrence. METHODS: Fifty-eight patients with TCCF underwent transarterial detachable-balloon embolization between October 2004 and March 2011. The clinical follow-up was performed every 3 months until up to 3 years postprocedure. Each patient was placed in either the recurrence group or the nonrecurrence group according to whether a recurrence developed after the first procedure. The relevant factors including gender, fistula location, interval between trauma and the interventional procedure, blood flow in the carotid-cavernous fistula, number of balloons, and whether the internal carotid artery (ICA) was sacrificed were evaluated. RESULTS: All 58 TCCFs were successfully treated with transarterial balloon embolization, including 7 patients with ICA sacrifice. Recurrent fistulas occurred in seven patients during the follow-up period. Univariate analysis indicated that the interval between trauma and the interventional procedure (p=0.006) might be the main factor related to the recurrence of TCCF. The second treatments involved ICA sacrifice in two patients, fistula embolization with balloons in four patients, and placement of a covered stent in one patient. CONCLUSIONS: Detachable balloons can still serve as the first-line treatment for TCCFs and recurrent TCCFs despite having a nonnegligible recurrence rate. Shortening the interval between trauma and the interventional procedure may reduce the risk of recurrence.