Neuroradiological treatment of carotid and vertebral fistulas and intracavernous aneurysms. Technical problems and results.

Thirty-three patients have been treated with balloon catheters since 1978. Debrun's detachable balloons were used in 31 and a Fogarty catheter in the other two. Problems were encountered from the introduction of the catheter to the detachment of the balloon. We have treated 21 fistulas between the internal carotid and cavernous sinus, 3 fistulas between the external carotid and jugular vein, 2 mixed fistulas between internal and external carotid and cavernous sinus, 2 vertebral fistulas and 5 intracavernous aneurysms. Delayed angiographic control has shown that the arterial axis remained patent in a high percentage of cases and that the formation of an asymptomatic pseudo-aneurysmal sac within the cavernous sinus is the rule. Long-term clinical follow-up has confirmed the angiographic results. In two patients neurological complications led to the patients' death.