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Acta Neurochirurgica
Published in: Acta Neurochirurgica 2/2010

01-02-2010 | Case Report

Direct puncture of a prematurely detached balloon in the supraclinoid ICA via the optic canal during embolisation of a traumatic carotid-cavernous fistula

Authors: C.-B. Luo, M.-M. H. Teng, C.-J. Lin, F.-C. Chang, C.-Y. Chang

Published in: Acta Neurochirurgica | Issue 2/2010

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Summary

We report a patient with traumatic carotid-cavernous fistula associated with an isolated internal carotid artery in whom, after trans-arterial balloon embolisation, premature balloon detachment occurred with balloon migration to the supraclinoid carotid artery, leading to total occlusion of the blood flow. The carotid flow was eventually restored by direct puncture of the detached balloon via the optic canal and by deploying a coronary stent to fix the balloon in the vascular wall. The fistula was eventually occluded by using detachable coils. He was discharged with a mild hemiparesis and decreased acuity in the left eye.
Literature
1.
Bendorf G, Bender A, Campi A, Memeking H, Lanksch WR (2001) Treatment of a cavernous sinus dural arterio-venous fistula by deep orbital puncture of the superior orbital fissure. Neuroradiology 43:499–502CrossRef
2.
Hallbach VV, Higashida RT, Barnwell SL, Dowd CF, Hieshima GB (1991) Trans-arterial platinum coil embolisation of carotid-cavernous fistulae. AJNR Am J Neuroradiol 12:429–433
3.
Luo CB, Teng MMH, Chang FC, Chang CY (2006) Trans-arterial balloon-assisted N-butyl-2-cyanoacrylate embolisation of direct carotid cavernous fistulae. AJNR Am J Neuroradiol 27:1535–1540PubMed
4.
Luo CB, Chang FC, Teng MMH, Chen SS, Lirng JF (2001) Enodvascular emoblisation of carotid-cavernous fistulae using the posterior communicating artery approach: a case report. Kaohsiung J Med Sci 17:112–115PubMed
5.
Teng MMH, Lirng JF, Chang T et al (1995) Embolisation of carotid-cavernous fistulae by means of direct puncture of superior orbital fissure. Radiology 194:705–711PubMed
6.
White JB, Layton KF, Evans AJ et al (2007) Trans-orbital puncture for the treatment of cavernous sinus dural arterio-venous fistulae. AJNR Am J Neuroradiol 28:1415–1417CrossRefPubMed
Metadata
Title
Direct puncture of a prematurely detached balloon in the supraclinoid ICA via the optic canal during embolisation of a traumatic carotid-cavernous fistula
Authors
C.-B. Luo
M.-M. H. Teng
C.-J. Lin
F.-C. Chang
C.-Y. Chang
Publication date
01-02-2010
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 2/2010
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-009-0319-0

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