Endovascular Treatment of a Direct Carotid Cavernous Sinus Fistula with the Woven EndoBridge Aneurysm Embolization System

Excerpt

A carotid-cavernous fistula (CCF) is a rare type of acquired arteriovenous shunt between the internal carotid artery (ICA) and the cavernous sinus (CS). The CCFs are commonly classified into four types (A–D) according to Barrow [1]. The type A CCF is characterized by a direct high-flow shunt between the ICA and CS. This type of fistula is usually caused by trauma or rupture of a cavernous aneurysm [1]. Caused by the arterialization of the superior ophthalmic vein and venous congestion, clinical presentations of direct CCF include acute proptosis, chemosis, headache, and visual impairment due to nerve palsy [1‐4]. The most common treatment of choice is endovascular transvenous embolization with coils or embolic material [5]. This article presents a case of direct CCF caused by a ruptured cavernous aneurysm treated with a Woven EndoBridge (WEB) device (MicroVention, Tustin, CA, USA). To our knowledge, this is the first time such an approach has been reported. …