Corrected by:
ErratumRofo 2008; 180(07): 613-613
DOI: 10.1055/s-2008-1027622
Zusammenfassung
Carotis-Cavernosus-Fisteln (CCF) machen etwa 12 % aller intrakraniellen arteriovenösen Fisteln aus und bestehen aus einer pathologischen Verbindung zwischen der Arteria carotis interna und/oder externa und dem Sinus cavernosus. In Abhängigkeit von der Anatomie und Pathophysiologie unterscheidet man zwischen direkten, meist traumatisch bedingten „High-flow”- und indirekten „Low-flow”-Fisteln. In beiden Fällen besteht die Behandlung in der Regel im endovaskulären Fistelverschluss, welcher seit den Fortschritten in der interventionellen Neuroradiologie während den letzten 15 Jahren die chirurgische Therapie weitgehend abgelöst hat. Diese Arbeit gibt eine Übersicht über die Anatomie und Pathophysiologie dieser Läsionen sowie über den aktuellen Stand der endovaskulären Behandlungsmöglichkeiten. Es werden Indikationen, Techniken und Ergebnisse interventioneller Eingriffe bei verschiedenen Typen von CCF dargestellt.
Abstract
This article provides an overview on the actual state of the interventional neuroradiological management of carotid cavernous fistulas depending on their anatomy and pathophysiology. The results are based on our experience gained during the treatment of patients with complex CCF during the last 15 years. Indications, procedures, and results of transarterial, transvenous and combined arteriovenous approaches for balloon occlusion, embolization, coiling and stenting of these lesions are discussed. Progress in this field is constant so that new technical advances are expected to improve the safety and to expand the indications for these procedures in the future.
Key words
carotid arteries - fistula - cerebral angiography - embolization - balloon insertions - stents
Literatur
-
1
Rhoton A L.
The cavernous sinus, the cavernous venous plexus, and the carotid collar.
Neurosurgery.
2002;
51
S375-S410
-
2
Barrow D L, Spector R H, Braun I F. et al .
Classification and treatment of spontaneous carotid-cavernous sinus fistulas.
J Neurosurg.
1985;
62
248-256
-
3
Debrun Jr G, Lacour P, Vinuela F. et al .
Treatment of 54 traumatic carotid-cavernous fistulas.
J Neurosurg.
1981;
55
678-692
-
4
Stiebel-Kalish H, Kalish Y, Bar-On R H. et al .
Presentation, natural history, and management of carotid cavernous aneurysms.
Neurosurgery.
2005;
57
850-857
-
5
Hahnel S, Stippich C, Hartmann M. et al .
Kraniale und zervikale arterielle Gefäßverletzungen: Bildgebung und Therapie.
Fortschr Röntgenstr.
2007;
179
119-129
-
6
Rooij W J, Sluzewski van M, Beute G N.
Ruptured cavernous sinus aneurysms causing carotid cavernous fistula: incidence, clinical presentation, treatment, and outcome.
Am J Neuroradiol.
2006;
27
185-189
-
7
Feiner L, Bennett J, Volpe N J.
Cavernous sinus fistulas: carotid cavernous fistulas and dural arteriovenous malformations.
Curr Neurol Neurosci Rep.
2003;
3
415-420
-
8
Barr J D, Mathis J M, Horton J A.
Iatrogenic carotid-cavernous fistula occurring after embolization of a cavernous sinus meningioma.
Am J Neuroradiol.
1995;
16
483-485
-
9
Lister J R, Sypert G W.
Traumatic false aneurysm and carotid-cavernous fistula: a complication of sphenoidotomy.
Neurosurgery.
1979;
5
473-475
-
10
Taniguchi R M, Goree J A, Odom G L.
Spontaneous carotid-cavernous shunts presenting diagnostic problems.
J Neurosurg.
1971;
35
384-391
-
11
Halbach V V, Higashida R T, Hieshima G B. et al .
Dural fistulas involving the cavernous sinus: results of treatment in 30 patients.
Radiology.
1987;
163
437-442
-
12
Houser O W, Baker H L, Rhoton A L Jr. et al .
Intracranial dural arteriovenous malformations.
Radiology.
1972;
105
55-64
-
13 Djindjian Jr R, Merland J J. Meningeal arteriovenous fistula. Djindjian R, Merland JJ, Théron J Superselective arteriography of the external carotid artery New York; Springer 1978: 606-628
-
14
Cognard C, Gobin Y P, Pierot L. et al .
Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage.
Radiology.
1995;
194
671-680
-
15
Borden J A, Wu J K, Shucart W A.
A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment.
J Neurosurg.
1995;
82
166-179
-
16
Willinsky R, Goyal M, terBrugge K. et al .
Tortuous, engorged pial veins in intracranial dural arteriovenous fistulas: Correlations with presentation location, and MR findings in 122 patients.
Am J Neuroradiol.
1999;
20
1031-1036
-
17
Mayer T E, Fesl G, Yousry T. et al .
Diagnosis and treatment of cranial arteriovenous dural fistulas.
Radiologe.
1999;
39
876-881
-
18
Cognard C, Houdart E, Casasco A. et al .
Long-term changes in intracranial dural arteriovenous fistulae leading to worsening in the type of venous drainage.
Neuroradiology.
1997;
39
59-66
-
19
Kupersmith M J, Berenstein A, Flamm E. et al .
Neuroophthalmologic abnormalities and intravascular therapy of traumatic carotid cavernous fistulas.
Ophthalmology.
1986;
93
906-912
-
20
Waldvogel D, Mattle H P, Sturzenegger M. et al .
Pulsatile tinnitus - a review of 84 patients.
J Neurol.
1998;
245
137-142
-
21
Halbach V V, Hieshima G B, Higashida R T. et al .
Carotid cavernous fistulae: indications for urgent treatment.
Am J Roentgenol.
1987;
149
587-593
-
22
Niamtu III J, Campbell R L.
Carotid cavernous fistula.
J Oral Maxillofac Surg.
1982;
40
52-56
-
23
Duan Y, Liu X, Zhou X. et al .
Diagnosis and follow-up study of carotid cavernous fistulas with color Doppler ultrasonography: analysis of 33 cases.
J Ultrasound Med.
2005;
24
739-745
-
24
Newton T H, Hoyt W F.
Dural arteriovenous shunts in the region of the cavernous sinus.
Neuroradiology.
1970;
1
71-81
-
25
Huber P.
A technical contribution of the exact angiographic localization of carotid cavernous fistulas.
Neuroradiology.
1976;
10
239-241
-
26 Huber P. Traumatische kraniozerebrale Schädigungen. Huber P Zerebrale Angiographie für Klinik und Praxis Stuttgart; Thieme 1979: 470-501
-
27
Lewis A I, Tomsick T A, Tew J M.
Management of 100 consecutive direct carotid-cavernous fistulas: results of treatment with detachable balloons.
Neurosurgery.
1995;
36
239-244
-
28
Courtheoux Jr P, Labbe D, Hamel C. et al .
Treatment of bilateral spontaneous dural carotid-cavernous fistulas by coils and sclerotherapy. Case report.
J Neurosurg.
1987;
66
468-470
-
29
Madan A, Mujic A, Daniels K. et al .
Traumatic carotid artery-cavernous sinus fistula treated with a covered stent. Report of two cases.
J Neurosurg.
2006;
104
969-973
-
30
Remonda L, Frigerio S B, Buhler R. et al .
Transvenous coil treatment of a type a carotid cavernous fistula in association with transarterial trispan coil protection.
Am J Neuroradiol.
2004;
25
611-613
-
31
Men S, Ozturk H, Hekimoglu B. et al .
Traumatic carotid-cavernous fistula treated by combined transarterial and transvenous coil embolization and associated cavernous internal carotid artery dissection treated with stent placement. Case report.
J Neurosurg.
2003;
99
584-586
-
32
Vinuela F, Fox A J, Debrun G M. et al .
Spontaneous carotid-cavernous fistulas: clinical, radiological, and therapeutic considerations. Experience with 20 cases.
J Neurosurg.
1984;
60
976-984
-
33
Halbach V V, Higashida R T, Hieshima G B. et al .
Transvenous embolization of dural fistulas involving the cavernous sinus.
Am J Neuroradiol.
1989;
10
377-383
-
34
Miller N R, Monsein L H, Debrun G M. et al .
Treatment of carotid-cavernous sinus fistulas using a superior ophthalmic vein approach.
J Neurosurg.
1995;
83
838-842
-
35
Jansen O, Dorfler A, Forsting M. et al .
Endovascular therapy of arteriovenous fistulae with electrolytically detachable coils.
Neuroradiology.
1999;
41
951-957
-
36
Halbach V V, Higashida R T, Barnwell S L. et al .
Transarterial platinum coil embolization of carotid-cavernous fistulas.
Am J Neuroradiol.
1991;
12
429-433
-
37
Siniluoto T, Seppanen S, Kuurne T. et al .
Transarterial embolization of a direct carotid cavernous fistula with Guglielmi detachable coils.
Am J Neuroradiol.
1997;
18
519-523
-
38
Klisch J, Huppertz H J, Spetzger U. et al .
Transvenous treatment of carotid cavernous and dural arteriovenous fistulae: Results for 31 patients and review of the literature.
Neurosurgery.
2003;
53
836-856
-
39
Teng M MH, Guo W Y, Lee L S. et al .
Direct Puncture of the Cavernous Sinus for Obliteration of A Recurrent Carotid-Cavernous Fistula.
Neurosurgery.
1988;
23
104-107
-
40
Wanke I, Doerfler A, Stolke D. et al .
Carotid cavernous fistula due to a ruptured intracavernous aneurysm of the internal carotid artery: treatment with selective endovascular occlusion of the aneurysm.
J Neurol Neurosurg Psychiatry.
2001;
71
784-787
-
41
Horton J A, Kerber C W.
Lidocaine Injection Into External Carotid Branches - Provocative Test to Preserve Cranial Nerve Function in Therapeutic Embolization.
Am J Neuroradiol.
1986;
7
105-108
-
42
Struffert T, Grunwald I Q, Mucke I. et al .
Interdisziplinäre Embolisation spontaner Karotis-Cavernosus-Fisteln Typ D nach Barrow über die Vena ophthalmica: klinische Langzeitergebnisse und kernspintomografische Befunde.
Fortschr Röntgenstr.
2007;
179
401-405
-
43
Eckert B, Schaudig U.
Endovascular treatment of extensive carotid cavernous fistulas by superior ophthalmic vein approach. Technique and illustration of two cases.
Ophthalmologe.
2004;
101
350-356
-
44
Keltner J L, Satterfield D, Dublin A B. et al .
Dural and carotid cavernous sinus fistulas. Diagnosis, management, and complications.
Ophthalmology.
1987;
94
1585-1600
-
45 Halbach V V, Higashida R T, Hieshima G B. et al .Endovascular therapy of dural fistulas. Vinuela F, Halbach VV, Dion JE Interventional Neuroradiology New York; Raven Press 1992: 29-38
-
46
Lewis A I, Tomsick T A, Tew J M. et al .
Long-term results in direct carotid-cavernous fistulas after treatment with detachable balloons.
J Neurosurg.
1996;
84
400-404
-
47
Higashida R T, Halbach V V, Tsai F Y. et al .
Treatment of Traumatic Carotid and Vertebral Artery Lesions by Interventional Neurovascular Techniques - Therapeutic Results in 234 Cases.
Am J Neuroradiol.
1989;
10
883
-
48
Guglielmi Jr G, Vinuela F, Duckwiler G. et al .
High-Flow, Small-Hole Arteriovenous-Fistulas - Treatment with Electrodetachable Coils.
Am J Neuroradiol.
1995;
16
325-328
-
49
Kanner A A, Maimon S, Rappaport Z H.
Treatment of spontaneous carotid-cavernous fistula in Ehlers-Danlos syndrome by transvenous occlusion with Guglielmi detachable coils - Case report and review of the literature.
J Neurosurg.
2000;
93
689-692
-
50
Hollands J K, Santarius T, Kirkpatrick P J. et al .
Treatment of a direct carotid-cavernous fistula in a patient with type IV Ehlers-Danlos syndrome: a novel approach.
Neuroradiology.
2006;
48
491-494
-
51
Das S, Bendok B R, Novakovic R L. et al .
Return of vision after transarterial coiling of a carotid cavernous sinus fistula: case report.
Surg Neurol.
2006;
66
82-85
-
52
Rai A T, Sivak-Callcott J A, Larzo C. et al .
Direct carotid cavernous fistula in infancy: Presentation and treatment.
Am J Neuroradiol.
2004;
25
1083-1085
-
53
Picard L, Bracard S, Moret J. et al .
Spontaneous Dural Arteriovenous-Fistulas. Semin Intervent Radiol.
1987;
4
219-241
-
54
Meyers P M, Halbach V V, Dowd C F. et al .
Dural carotid cavernous fistula: definitive endovascular management and long-term follow-up.
Am J Ophthalmol.
2002;
134
85-92
-
55
Kirsch M, Henkes H, Liebig T. et al .
Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients.
Neuroradiology.
2006;
48
486-490
-
56
Day J D, Fukushima T.
Direct microsurgery of dural arteriovenous malformation type carotid-cavernous sinus fistulas: indications, technique, and results.
Neurosurgery.
1997;
41
1119-1124
-
57
Nakagawa N, Akai F, Fukawa N. et al .
Endovascular stent placement of cervical internal carotid artery dissection related to a seat-belt injury: a case report.
Minim Invasive Neurosurg.
2007;
50
115-119
-
58
Moron F E, Klucznik R P, Mawad M E. et al .
Endovascular treatment of high-flow carotid cavernous fistulas by stent-assisted coil placement.
Am J Neuroradiol.
2005;
26
1399-1404
-
59
Moret J, Cognard C, Weill A. et al .
Reconstruction technique for wide neck intracranial aneurysms: Long-term angiographic and clinical results in a series of 56 cases.
J Neuroradiol.
1997;
24
30-44
-
60
Morris P P.
Balloon reconstructive technique for the treatment of a carotid cavernous fistula.
AJNR Am J Neuroradiol.
1999;
20
1107-1109
-
61
Saatci I, Cekirge H S, Ozturk M H. et al .
Treatment of internal carotid artery aneurysms with a covered stent: experience in 24 patients with mid-term follow-up results.
Am J Neuroradiol.
2004;
25
1742-1749
-
62
Alexander M J, Smith T P, Tucci D L.
Treatment of an iatrogenic petrous carotid artery pseudoaneurysm with a Symbiot covered stent: technical case report.
Neurosurgery.
2002;
50
658-62
Prof. Dr. Gerhard Schroth
Institut für Diagnostische und Interventionelle Neuroradiologie, Universität Bern
Inselspital
CH-3010 Bern
Phone: ++ 41/31/6 32 26 54
Fax: ++ 41/31/6 32 48 72
Email: gerhardschroth@insol.ch
