William Pedersen MD, Presenter: Nothing to Disclose

Malaykumar Manilal Patel MD, Abstract Co-Author: Nothing to Disclose

J. Scott Williams MD, PhD, Abstract Co-Author: Nothing to Disclose

Steven Thomas Reed MD, Abstract Co-Author: Nothing to Disclose

1. Review of historic and current endovascular therapies 2. Selecting the optimal endovascular treatment  

Introduction: First treated surgically in early nineteenth century with carotid artery ligation, initial evolution of CCF treatment was limited to advancements in open surgical techniques. The innovation of modern endovascular techniques in the 1970s revolutionized treatment, reducing morbidity and mortality. The treatment of CCFs has evolved as catheter directed techniques have continued to advance. Pathophysiology: An arteriovenous fistula between the highly pressurized ICA and low pressure cavernous sinus results in hypertension in the cavernous sinus and the structures it drains, principally the orbit. Angiography: Initial angiography defines the anatomy and clarifies high-risk features such as cortical venous drainage, pseudoaneurysm, cavernous sinus varix and dangerous collateral pathways. Endovascular therapy: Obliteration of the fistula can be achieved by parent vessel sacrifice, embolization of the fistulous communication using a variety of materials and approaches, or through the use of an arterial covered stent. Conclusion: Endovascular intervention has evolved dramatically and is the most viable treatment option for CCF.  

http://abstract.rsna.org/uploads/2014/14011570/14011570_2tgb.pdf

Pedersen, W, Patel, M, Williams, J, Reed, S, Direct Carotid Cavernous Sinus Fistulas: Evolving Endovascular Therapeutic Techniques.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011570.html