A review on endovascular techniques for treatment of direct post-traumatic carotid-cavernous fistula supported by case presentations.

Direct carotid-cavernous fistula is an abnormal arteriovenous communication between the carotid artery and the cavernous sinus occurring spontaneously or following head trauma. The aim of this paper is to report our experience and a review of the literature regarding the curative effect of endovascular treatment for patients with post-traumatic direct CCF. We present five patients with direct post-traumatic CCF in whom endovascular treatment was applied and the outcomes of the endovascular treatment. Direct post-traumatic CCF may be completely occluded without technique-related complications using detachable balloons, coils as embolic material or by using covered stents placed in the parent vessel to exclude the fistula from circulation. Postembolization angiographies revealed that the fistula was successfully obliterated. Few days after the procedure the ophthalmic symptoms were much reduced, and completely resolved soon after.In conclusion endovascular treatment represents an effective method for complete occlusion the direct CCF no matter of the technique chosen.