Carotid Cavernous Fistula

Neurosurg Clin N Am. 2024 Jul;35(3):319-329. doi: 10.1016/j.nec.2024.02.004. Epub 2024 Mar 19.

Abstract

Carotid cavernous fistulae (CCFs) are arteriovenous shunts involving the cavernous sinus. CCFs are defined as direct or indirect. Direct CCFs are treated by deconstructive or reconstructive techniques depending on whether the affected internal carotid artery is required to perfuse the ipsilateral cerebral hemisphere, as determined by a balloon test occlusion. Indirect CCFs, or dural fistulae of the cavernous sinus wall, are most often treated with transvenous embolization. Stereotactic radiosurgery is reserved for cases of indirect CCFs that are not completely obliterated by embolization. Overall, cure rates are high with relatively low complication rates.

Keywords: Arteriovenous fistula; Carotid artery; Cavernous sinus; Dural; Fistula.

Publication types

  • Review

MeSH terms

  • Carotid-Cavernous Sinus Fistula* / diagnostic imaging
  • Carotid-Cavernous Sinus Fistula* / surgery
  • Carotid-Cavernous Sinus Fistula* / therapy
  • Cavernous Sinus / diagnostic imaging
  • Cavernous Sinus / surgery
  • Embolization, Therapeutic* / methods
  • Humans
  • Radiosurgery / methods