Comparison between different modalities of Endovascular treatment in Carotid Cavernous Fistula (CCF) and its short term outcome – Our Experience

Authors

  • Mst Shamima Sultana Neurosurgeon, Assistant Registrar, Department of Neurosurgery, Rangpur Medical College Hospital, Rangpur, Bangladesh
  • Md Shafiqul Islam Associate Professor, Department of Neurosurgery , Dhaka Medical College, Dhaka, Bangladesh
  • Md Sumon Rana Medical Officer, Department of Neurosurgery , Dhaka Medical College Hospital Dhaka, Bangladesh
  • Kanij Fatema Ishrat Zahan Rifat Assistant Professor, Department of Neurosurgery , Dhaka Medical College, Dhaka, Bangladesh
  • Md Abul Kalam Azad Assistant Professor, Department of Medicine, Rangpur Medical College, Rangpur Bangladesh
  • Md Motasimul Hasan RS Neurosurgery, Dhaka Medical College Hospital, Dhaka, Bangladesh
  • Ayub Ansari Associate Professor, Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh
  • Asit Chandra Sarker Professor and Head, Department of Neurosurgery, Dhaka Medical College, Dhaka, Bangladesh
  • ANM Ilias Assistant Professor, Department of Neurosurgery, Comilla Medical College, Bangladesh
  • Md Rezaul Alam Associate Professor Neurosurgery. Rajshai Medical College, Rajshahi

DOI:

https://doi.org/10.3329/bjns.v8i2.42347

Keywords:

Carotid, cavernous, fistula, endovascular treatment, balloon assisted sinus coiling

Abstract

Introduction: Endovascular treatment offers different technique (Balloon assisted coiling / simple coiling, glue embolization) to treat Carotid Cavernous Fistula (CCF). This less invasive approach avoids morbidity and residual fistulas. The choice of treatment depends on the anatomy of the fistulas and cost effectiveness.

Objective: To describe different endovascular treatment option of Carotid Cavernous fistulas (CCF), its short term outcome (clinical and angiographical) and to compare between trans-venous coiling and trans-arterial balloon assisted sinus coiling.

Method: We have treated nine (9) cases of CCF during a period of three years. Out of them eight patients had direct CCF and one had indirect CCF. In two patients simple coiling done through trans-venous route and in another three patients through trans-arterial route. Balloon assisted coiling through trans-arterial route done in three patients. In two patients trans-arterial glue embolization was done.

Results: Successful obliteration of fistula was achieved in all cases. Vision was improved in eight (8) patients. Postoperatively some proptosis remains in two patients. In one patient there was reappearance of proptosis two months after treatment, then balloon assisted coiling was done. One patient died from complication of glue (NBCA). Conclusion: Endovascular treatment is the mainstay of treatment in CCF. Trans-venous is the treatment of choice but recently balloon assisted sinus coiling through trans-arterial route is adopted.

Bang. J Neurosurgery 2019; 8(2): 68-76

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Published

2019-07-24

How to Cite

Sultana, M. S., Islam, M. S., Rana, M. S., Rifat, K. F. I. Z., Azad, M. A. K., Hasan, M. M., Ansari, A., Sarker, A. C., Ilias, A., & Alam, M. R. (2019). Comparison between different modalities of Endovascular treatment in Carotid Cavernous Fistula (CCF) and its short term outcome – Our Experience. Bangladesh Journal of Neurosurgery, 8(2), 68–76. https://doi.org/10.3329/bjns.v8i2.42347

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Original Articles