The Superior Ophthalmic Vein Approach for the Treatment of Carotid-Cavernous Fistulas: Our First Experience
Dante Valer1, Rafael Morales2, Lucía Gárate3 and Eduardo Mendez MT4
Applied Medical Research. 2021;
Carotid cavernous fistulas (CCF) constitute between 10-15% of all intracranial vascular malformations.
Clinical symptoms of indirect CCFs include chemosis, conjunctival injection, proptosis, diminished visual
acuity, ophthalmoplegia, retro-orbital bruit, periorbital swelling, and hyperlacrimation, in the setting of
associated cortical venous reflux, intracranial hemorrhage. Treatment of choice for symptomatic carotid
cavernous and cavernous dural fistulas is neuroradiologic intervention via the femoral artery. Owing to the
location of the fistula and/or to anatomic variations, a direct surgical approach via the superior ophthalmic
vein may be necessary for embolization.