American Association of Neurological Surgeons | Trans-superior ophthalmic vein approach for treatment of carotid-cavernous fistula @AANSNeurosurgery | Uploaded November 2021 | Updated October 2024, 1 hour ago.
Visish M. Srinivasan, MD,1 Anish N. Sen, MD,2 and Peter Kan, MD, MPH1

1Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and 2Department of Neurosurgery, Loma Linda University, Loma Linda, California

The authors present a case of a patient with a Barrow Type B carotid-cavernous fistula (CCF) who presented with severe symptoms of eye redness, diplopia, and proptosis. Due to the tortuosity and size of her angular vein and the lack of good flow/access via the inferior petrosal sinus, she was treated with a transvenous approach via a large, dilated superior ophthalmic vein for coil embolization of the CCF. The patient had a full angiographic and symptomatic cure. The authors present the treatment plan and strategy and the fluoroscopic recording of the treatment. Nuances of the technique are discussed.

Include when citing: Published online April 1, 2019; DOI: thejns.org/doi/abs/10.3171/2019.2.FocusVid.18496.