Advantage of Balloon Guide Catheter During Endovascular Treatment of Direct Carotid-Cavernous Sinus Fistula: Technical Note and Report of 2 Cases

World Neurosurg. 2021 Jan:145:251-255. doi: 10.1016/j.wneu.2020.09.058. Epub 2020 Sep 23.

Abstract

Background: As previous studies reported, the balloon guide catheter is useful for identifying the fistula point during diagnosis of direct carotid-cavernous sinus fistula (d-CCF). We demonstrate an additional advantage of the balloon guide catheter during intraarterial endovascular treatment of d-CCF.

Methods: Two cases of d-CCF are presented in this report. A balloon guide catheter is used to help achieve successful coil embolization of the fistula in both cases.

Results: Microcatheter positioning into the fistulous point can be easier after balloon inflation. Balloon inflation can help with coil deployment.

Conclusions: Using a balloon guiding catheter can reduce internal carotid artery flow near the fistula point at the cavernous segment of the internal carotid artery. As a result, better identification of the fistula point can be made, which allows easier placement of the microcatheter into the fistula point and more stable coil deployment.

Keywords: Balloon occlusion; Carotid-cavernous sinus fistula; Embolization.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Adult
  • Carotid Artery, Internal / surgery
  • Carotid-Cavernous Sinus Fistula / drug therapy
  • Carotid-Cavernous Sinus Fistula / surgery*
  • Catheterization / instrumentation
  • Catheterization / methods*
  • Catheters*
  • Cerebral Angiography
  • Embolization, Therapeutic / methods
  • Endovascular Procedures / methods*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Tomography, X-Ray Computed
  • Young Adult