Indications for alternative endovascular techniques in carotid-cavernous fistulas: A 20-year single-center experience

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61383082%3A_____%2F24%3A00001392" target="_blank" >RIV/61383082:_____/24:00001392 - isvavai.cz</a>

Result on the web

<a href="https://pubmed.ncbi.nlm.nih.gov/38173239/" target="_blank" >https://pubmed.ncbi.nlm.nih.gov/38173239/</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1177/15910199231217549" target="_blank" >10.1177/15910199231217549</a>

Result language

angličtina

Original language name

Indications for alternative endovascular techniques in carotid-cavernous fistulas: A 20-year single-center experience

Original language description

Background: While coiling is considered the standard treatment for carotid-cavernous fistulas (CCFs), studies demonstrating excellent results using new materials, especially flow diverter (FD) stents and liquid embolisates, are becoming more frequent. The indications and effectiveness of these alternative endovascular techniques remain unclear. Methods: A total of 22 direct and 20 indirect CCFs were included in the study. These were further subdivided based on the embolic material used: coils versus FD stents for direct and coils versus liquid embolisates for indirect CCFs. The subgroups were subjected to statistical analysis. Results: An angiographic cure was achieved in 88% of all CCFs, 93% of patients’ experienced clinical improvement or remained stable. Direct CCFs were treated with coiling (41%) or with both coils and FD stents (55%). One (4%) patient with a direct CCF was treated with FD stent alone. Statistical analysis comparing these subgroups revealed a significantly higher complete occlusion rate immediately after treatment in the coiling subgroup (67% vs. 23%, p = 0.0409). The occlusion rates at the last follow-up were similar (89% vs. 85%). Indirect CCFs were treated with coiling (35%) or liquid embolisates (65%). All three periprocedural ischemic complications were recorded within the liquid subgroup, resulting in a significantly higher clinical deterioration rate (p = 0.0333). Conclusion: FD stents in direct and liquid embolisates in indirect fistulas did not demonstrate better angiographic or clinical outcomes compared to convetional coiling. Liquid agents carried a higher risk of ischemic complications. Alternative embolization materials should be reserved for CCFs that cannot be treated with simple coiling.

Czech name

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Czech description

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Type

J_imp - 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)

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)

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Interventional Neuroradiology

ISSN

1591-0199

e-ISSN

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Volume of the periodical

Jan 2024

Issue of the periodical within the volume

Jan 3

Country of publishing house

US - UNITED STATES

Number of pages

9

Pages from-to

1-9

UT code for WoS article

001136484900001

EID of the result in the Scopus database

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