Contralateral transvenous approach and embolization with 360° guglielmi detachable coils for the treatment of cavernous sinus dural fistula

Abstract

carotid-cavernous fistulas are spontaneous or acquired connections between the carotid artery and the cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathologies such as pregnancy, sinusitis and cavernous sinus thrombosis. They are clinically characterized by ophthalmological symptoms and pulsatile tinnitus. A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity. Carotid-cavernous fistula was diagnosed, for the technical difficulty inherent in the case was made a contralateral transvenous approach and embolization with 360 ° GDG coils, with successful evolution of the patient. The endovascular management of these lesions is currently possible with excellent results.