ArticleFrontiers in neurology2025
Endovascular management of carotid-cavernous fistulas: a 16-year retrospective analysis of multimodal treatment strategies and long-term clinical outcomes.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Differentiating high-flow vascular lesions from clinical and hemodynamic mimics in the head and neck: a pattern-based multimodality imaging approach.Neuroradiology · 2026Review
- Article
- Unusual Venous-Origin Intraparenchymal Hematoma in the Context of a Post-traumatic Carotid-Cavernous Fistula.Cureus · 2025Article
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8 authors.
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Abstract
Background: Carotid-cavernous fistulas (CCFs) are abnormal connections between the carotid artery and/or its branches and the cavernous sinus, potentially resulting in significant complications, including visual impairment and neurological deficits. Timely diagnosis and appropriate therapeutic intervention are critical to minimizing the risk of adverse outcomes. Over the years, endovascular techniques have become the preferred method for treating CCFs, offering high success rates with fewer complications. This study aims to study the clinical and radiological outcomes of patients with CCFs treated with endovascular approaches, and to identify key prognostic factors associated with treatment efficacy and symptomatic resolution. Methods: A retrospective analysis was conducted of patients diagnosed with carotid-cavernous fistulas (CCFs) and treated at the National Center for Neurosurgery in Astana, Kazakhstan, between 2008 and 2024. A total of 71 patients underwent endovascular embolization using either transarterial or transvenous techniques. According to the Barrow classification, type A CCF were observed in 62 patients (87.3%), type D in 7 patients (9.9%), and types B and C in 1 patient each (1.4%). Collected data included patient demographics, type of embolic materials utilized, number of procedures performed, treatment approach, and corresponding radiological and clinical outcomes. Results: Among the 71 patients included in the study, 80.3% achieved complete clinical resolution, 15.5% demonstrated partial improvement, and 4.2% experienced no clinical benefit. The mean age was 35.7 ± 12.9 years, with 71.8% males. Clinical outcomes were significantly associated with complete occlusion following the initial intervention ( Conclusion: Endovascular embolization is a safe and effective first-line treatment modality for CCFs. Both transarterial and transvenous approaches offer comparable rates of clinical success. Achieving complete occlusion is a critical determinant of favorable clinical outcomes and is associated with a reduced risk of treatment-related complications.
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