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2008, Number 4

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Rev Hosp Jua Mex 2008; 75 (4)

Primer caso de fístula carótido-cavernosa Barrow A, tratado mediante terapia endovascular en el Hospital Juárez de México

Melo GG, Reyes SG, Mendizábal GR, Acosta GR, Ayala AA, Jiménez JM, Hernández LGD

Language: Spanish
References: 27
Page: 281-286
PDF size: 236.41 Kb.


ABSTRACT

Introduction. Carotid cavernous fistulas are sites of communication abnormally acquired between the internal carotid artery and the cavernous sinus. We reported the first case of posttraumatic carotid cavernous fistula treated by endovascular therapy at Hospital Juarez de Mexico. Presentation of case: 29 years old female, Chinese origin, one month previous she was suffered a severe toraco-abdominal and cranioencephalic trauma by automobile accident. She presented a Thrill in the left eye with diameter of 5 cm, ciliary and conjuntival injection with chemosis. Brain angiography showed one fistula of the left cavernous carotid artery and left carotid cavernous sinus with high flow, during the procedure we made embolization with eight coils, the arterial route was used with Seldinger technique. One month after pursuit does not feel Thrill, diminution of conjuntival injection and absence of chemosis. Discussion. An emergency is considered when it exists lost of the vision, hemiplejia, massive epistaxis or intraocular pressure greater than 40 milimiters of mercury. At the moment the use of detachable coils by transarterial route, particularly with medium and small fistulas, are greater utility like in our patient. The risk of internal carotid artery occlusion and paralysis of oculomotors muscles with endovascular therapy are present in 10-40% of the patients. Conclusions. The treatment of traumatic carotid cavernous fistula by means of endovascular therapy is effective; there were not complications during the procedure in our reported case.


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