Angiology: Open Access
Open Access

Abstract

Carotid-Cavernous Fistula: Natural history and Clinical Profile

Kumudini Sharma, Rachna Agarwal, Vikas kanaujia, Vivek Singh, Priyadarshini Mishra and Phadket RV

Purpose: To evaluate the presentation, clinical course and outcome of carotid-cavernous fistula (CCF) cases with endovascular treatment in our institution during the last 10 years.

Methods: It is a prospective, protocol- based study of 45 consecutive cases who had presented in our Neuro-ophthalmology department from 2005 to 2015. Detailed history and complete neuro-ophthalmic examination along with relevant investigations and treatment was done. The patients were followed up immediately after the procedure and at three monthly intervals for one year and then yearly.

Results: In our study the age range is from 3 to 63 years. Of the total 45 cases 42 had direct CCF while 3 cases were of dural CCF . Orbital and neuro-ophthalmological symptoms and signs were most common clinical presentation at diagnosis. All the cases but one responded well to transfemoral balloon/coil embolization in our institute Conclusion: CCF mostly have classical presentation but few cases can cause a diagnostic dilemma and so the ophthalmologist have to be observant about the disease. Early diagnosis results into least morbidity. Timely intervention with endovascular coiling results in successful closure of the fistula .