Natural course of partially embolized carotid-cavernous fistulas
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61383082%3A_____%2F24%3A00001369" target="_blank" >RIV/61383082:_____/24:00001369 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/24:10479627
Result on the web
<a href="https://pubmed.ncbi.nlm.nih.gov/38343141/" target="_blank" >https://pubmed.ncbi.nlm.nih.gov/38343141/</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1111/jon.13192" target="_blank" >10.1111/jon.13192</a>
Alternative languages
Result language
angličtina
Original language name
Natural course of partially embolized carotid-cavernous fistulas
Original language description
Background and Purpose: To present the first study analyzing the clinical and radiological course of carotid-cavernous fistulas (CCFs) following incomplete embolization. The study compares magnetic resonance angiography (MRA) to plain angiography (digital subtraction angiography [DSA]) and investigates the long-term ophthalmological impact of residual fistula. Methods: Fistulas classified as partially embolized after the last endovascular treatment were prospectively followed with DSA, MRA, and ophthalmological examination. Both direct and indirect CCFs were included. Results: Twenty-one CCFs were included in the study. Nine (43%) fistulas were direct and 12 (57%) were indirect. A favorable clinical outcome of modified Rankin scale ≤2 was recorded in 19 (90%) patients at the last follow-up. Postinterventional ophthalmologic examinations in 16 patients revealed no negative effects of residual fistulas; five remaining patients refused to undergo further examination. Spontaneous thrombosis and complete occlusion of the CCF were demonstrated in 90% of patients, with a mean time to occlusion of 5.7 ± 4.7 months. Fourteen (66%) patients completed the full imaging follow-up (MRA and DSA). In 21% of these cases, discrepancy between the two imaging modalities was observed—MRA failed to detect persistent fistulas identified by DSA. Conclusions: The goal of CCF treatment is safe and complete embolization. However, if adequate flow reduction is achieved, both direct and indirect CCFs tend to spontaneously thrombose. Residual flow does not result in ophthalmological deterioration until the fistula is completely closed. MRA may not be sufficiently sensitive to detect residues of fistulas including cortical venous drainage. Therefore, complete CCF closure should be confirmed through DSA.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30103 - Neurosciences (including psychophysiology)
Result continuities
Project
<a href="/en/project/NV19-04-00270" target="_blank" >NV19-04-00270: Assessment of hemodynamic parameters of stable and unstable atherosclerotic plaques in the carotid arteries in in vitro models</a><br>
Continuities
P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)
Others
Publication year
2024
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
JOURNAL OF NEUROIMAGING
ISSN
1051-2284
e-ISSN
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Volume of the periodical
34
Issue of the periodical within the volume
3
Country of publishing house
US - UNITED STATES
Number of pages
10
Pages from-to
376-385
UT code for WoS article
001160337200001
EID of the result in the Scopus database
2-s2.0-85185116996