Neuroendovascular management of carotid cavernous fistulae.

Carotid-cavernous fistulae are abnormal arterial communications within the cavernous sinus. Endovascular obliteration is the mainstay therapy for the definitive treatment of these lesions. Several approaches have been described. These include transarterial or transvenous embolization with balloons, coils, particles, or covered stents, and arterial sacrifice. The preferred technique is based on the fistula type (direct or indirect), microanatomy, chronicity, and the extent of the arterial defect.