Embolizaçao de fístula carótido-cavernosa com conservação da circulação arterial: registro de um caso

Troijo, Ariovaldo

doi:10.1590/S0004-282X1979000300013

Resumos

É relatado um caso de fistula carótido-cavernoso de alto fluxo, rotura de aneurisma intracavernoso congênito, associado a outro aneurisma contralateral intacto, com início de exoftalmo contralateral e a seguir exoftalmo bilateral; foi bom o resultado obtido por embolização com embolo muscular pequeno controlado por um fio de nylon e preservação da circulação da carótida ao nível da fistula. O autor enfatiza a simplicidade desta técnica e tece comentários sobre as outras técnicas recomendadas para casos semelhantes.

A case of carotid cavernous fistula of high flow by rupture of intracavernous aneurysm with similar intracavernous aneurysm not ruptured is reported. Good results were obtained by muscle embolus technique controlled by a thread, with preservation of the circulation of the carotid artery. The author emphasizes the simplicity of this technique and comments other techniques registered in the literature.

Embolizaçao de fístula carótido-cavernosa com conservação da circulação arterial: registro de um caso

Carotid-cavernous fistulas embolized with conservation of the arterial circulation: a case report

Ariovaldo Troijo

Neurocirurgifto do Hospital Dr. Paulo Sacramento, Jundial, SP

RESUMO

É relatado um caso de fistula carótido-cavernoso de alto fluxo, rotura de aneurisma intracavernoso congênito, associado a outro aneurisma contralateral intacto, com início de exoftalmo contralateral e a seguir exoftalmo bilateral; foi bom o resultado obtido por embolização com embolo muscular pequeno controlado por um fio de nylon e preservação da circulação da carótida ao nível da fistula. O autor enfatiza a simplicidade desta técnica e tece comentários sobre as outras técnicas recomendadas para casos semelhantes.

SUMMARY

A case of carotid cavernous fistula of high flow by rupture of intracavernous aneurysm with similar intracavernous aneurysm not ruptured is reported. Good results were obtained by muscle embolus technique controlled by a thread, with preservation of the circulation of the carotid artery. The author emphasizes the simplicity of this technique and comments other techniques registered in the literature.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Serviço de Neurocirurgia e Neurologia - Hospital Dr. Paulo Sacramento - 13200 Jundiai, SP - Brasil.

1. ARUTIUNOV, A. I.; SERBINENKO, F. A. & SHLYKOV, A. A. - Surgical treatment of carotid cavernous fistulas. Progr. Brain. Res. 30:441, 1969.
2. BLACK, P.; VEMATSU, S.; PEROVIC, M. & WALKER, E. A. - Carotid cavernous fistula: a controlled embolus technique for oclusion of fistula with preservation of carotid blood flow. J. Neurosurg. 38:113, 1973.
3. BROOKS, B. - Treatment of arteriovenous fistula. Southern Med. J. 23:100, 1930.
4. BRIHAYE, J.; HOFFMANN, G. R.; FRANCOIS, J. & BRIHAYE-VAN GEER-TRUYDEN, M. - Les exophatalmies neurochirurgicales. Neurochir. (Paris) 14:249, 1968.
5. DANDY, W - The treatment of carotid cavernous aneurysms. Ann. Surg. 102:916, 1935.
6. DANDY, W. - The treatment of carotid cavernous arterio-venous aneurysms withim the cavernous sinus and cranial chamber. Ann. Surg. 109:689, 1939.
7. ECHOLS, D. H. & JACKSON, J. D. - Carotid cavernous fistula: a perplexing surgical problem. J. Neurosurg. 16:618, 1959.
8. GUIOT, G.: PIWNICA, A.; VOURC'H, G.; WEISS, M.; DJINDJIAN, R.; ARFEL, G.; ARQUEZ, L. & RETT, A. - Anéurysme carotido-caverneux óperé sous hypo-thermie profonde avec arret circulatoire. An. Académie de Chirurgie. Séance du 31 Janvier 1966.
9. HAMBY, W. B. & DOHN, D. F. Carotid-cavernous fistulas: report of thirty-six cases with discussion of their management. Clin. Neurosurg. 11:150, 1964.
10. HAMBY, W. B. & GARDNER, W. J. - Treatment of pulsation exophthalmos with report of two cases. Arch. Surg. (Chicago) 27:676, 1933.
11. HAMBY, W. B. - Carotid cavernous fistula: report of 32 surgically treated cases and suggestions for definitive operation. J. Neurosurg. 21:859, 1964.
12. HAYES, G. J. - External carotid cavernous sinus fistula. J. Neurosurg. 20:692, 1963.
13. ISAMAT, F.; SALLERAS, V. & MIRANDA, M. - Artificial embolization of carotid cavernous fistulas with postoperative patency of internal carotid artery. J. Neurol. Neurosurg. Psychiatr. 33:674, 1970.
14. KOSARY, I. Z.; LERNER, N. A.; MOZES, M. & LAZAR, M. - Artificial embolic occlusion of the internal carotid artery in the treatment of carotid cavernous fistula. J. Neurosurg. 28:605, 1968.
15. KRAYENBÜHL, H. A. & YASARGIL, M. G. - Cerebral Angiography. Butterworth & Co. London, 1968.
16. KRAYENBÜHL, H. A. - Unilateral exophthalmos. Clin. Neurosurg. 14:45, 1967.
17. KRAYENBÜHL, H. A. - Treatment of carotid cavernous fistula consisting of a one stage operation by muscle embolization of the fistulas carotid segment. In DONAGHY, R.M.P. & YASARGIL, M. G. - Microvascular Surgery, p. 151-167. C. V. Mosby e G. Thiene, Saint Louis e Stuttgart, 1967.
18. LANG, R. E. & BUCY, P. C. - Treatment of carotid cavernous fistlua by muscle embolization alone: the Brooks method. J. Neurosurg. 27:387, 1965.
19. LE XUAN TRUNG; NGUYEN THUONG XUAN & TON THAT TUNG - Traitment des fistules carotido-caverneuses par embols musculaires. Chirurgie 98:70, 1972.
20. MATTOS PIMENTA, A.; MARQUES, J. S. & BONATELLI, A. P. F. - Fistula carótido-cavernosa. Seara Médica Neurocirurgica. 1:277, 1973.
21. OBRADOR, S.; GOMEZ-BUENO, J. & RODA, E et al. - Fistulas carotido-caver-nosas. XXV Meeting Spanish-Portuguese Society of Neurosurgery. April 1973.
22. OHTA, T.; NISHIMURA, S.; KIKUCHI, H. & TOYAMA, M. - Closure of carotid fistula with polyrethane foam embolus. J. Neurosurg. 38:107, 1973.
23. PARKINSAON, D. - Carotid cavernous fistula: diret repair with preservation of the carotid artery. J. Neurosurg. 38:99, 1973.
24. PROLO, D. J. & HAMBERY, J. W. - intraluminal oclusion of a carotid-cavernous sinus fistula with a balloon catheter: technical note. J. Neurosurg. 35:237, 1971.
25. REY, A.; COPHIGNON, J.; THUREL, Cju. & THIEBAUT, J. B. - Treatment of traumatic cavernous fistulas. In KRAYENBÜHL, H., ed. - Advances and Technical Standards in Neurosurgery, vol. 2:87, 1975.
26. ROUGERIE; J.; GUILMET, D.: BAMBERGER & BOZO, C. - Anévrysme carotido-caverneux: A propôs d'une orientation thérapeutique nouvelle. Neurochirurgie. 19:649, 1973.
27. SAUNDERS, M. D. & HOYT, N. F. - Hipoxic ocular seqüelas of carotid cavernous fistulas: study of the causes of visual failure before and after neurosurgical treatment in a series of 25 cases. British J. Ophth. 53:82, 1969.
28. STROOBANDT, G.; CONNELIS, G.; DECHEF, K. & EURAND, P. - Aspects circulatoires particuliers des fistules carotido-caverneuses. Neurochirurgie. 18:333, 1972.
29. TAPTAS, J. N. - Le traitement des anévrysmes carotido-caverneux par embolization de la carótide interne cervicale. A propôs de trois cas dont un d' anévrysme carotido-caverneux bilateral, traités par embolization musculaire. Rev. Neurol. (Paris). 124:277, 1971.
30. VOIGT, K.; SAUER, M. & DICHGANS, J. - Spontaneous oclusion of a bilateral carotido-cavernous fistula studied by serial angiography. Neuroradiology. 2:207, 1971.
31. WANISSORN, R. - Mechanism of experimental muscle embolization of the carotid cavernous fistula and the fate of the emboli. J. Neurosurg. 32:344. 1970.
32. YASARGIL, M. G. - Microsurgery Applied to Neurosurgery. G. Thieme, Stuttgart, 1969.
33. ZIMMAN, J.; ZIMMAN, L. & ZIMMAN, S. - Orientacion Neuroquirurgica. Editorial Bibliográfica Omeba, S.A. 1963.

Datas de Publicação

Publicação nesta coleção
21 Ago 2012
Data do Fascículo
Set 1979

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARUTIUNOV, A. I.; SERBINENKO, F. A. & SHLYKOV, A. A. - Surgical treatment of carotid cavernous fistulas. Progr. Brain. Res. 30:441, 1969.

[2] 2. BLACK, P.; VEMATSU, S.; PEROVIC, M. & WALKER, E. A. - Carotid cavernous fistula: a controlled embolus technique for oclusion of fistula with preservation of carotid blood flow. J. Neurosurg. 38:113, 1973.

[3] 3. BROOKS, B. - Treatment of arteriovenous fistula. Southern Med. J. 23:100, 1930.

[4] 4. BRIHAYE, J.; HOFFMANN, G. R.; FRANCOIS, J. & BRIHAYE-VAN GEER-TRUYDEN, M. - Les exophatalmies neurochirurgicales. Neurochir. (Paris) 14:249, 1968.

[5] 5. DANDY, W - The treatment of carotid cavernous aneurysms. Ann. Surg. 102:916, 1935.

[6] 6. DANDY, W. - The treatment of carotid cavernous arterio-venous aneurysms withim the cavernous sinus and cranial chamber. Ann. Surg. 109:689, 1939.

[7] 7. ECHOLS, D. H. & JACKSON, J. D. - Carotid cavernous fistula: a perplexing surgical problem. J. Neurosurg. 16:618, 1959.

[8] 8. GUIOT, G.: PIWNICA, A.; VOURC'H, G.; WEISS, M.; DJINDJIAN, R.; ARFEL, G.; ARQUEZ, L. & RETT, A. - Anéurysme carotido-caverneux óperé sous hypo-thermie profonde avec arret circulatoire. An. Académie de Chirurgie. Séance du 31 Janvier 1966.

[9] 9. HAMBY, W. B. & DOHN, D. F. Carotid-cavernous fistulas: report of thirty-six cases with discussion of their management. Clin. Neurosurg. 11:150, 1964.

[10] 10. HAMBY, W. B. & GARDNER, W. J. - Treatment of pulsation exophthalmos with report of two cases. Arch. Surg. (Chicago) 27:676, 1933.

[11] 11. HAMBY, W. B. - Carotid cavernous fistula: report of 32 surgically treated cases and suggestions for definitive operation. J. Neurosurg. 21:859, 1964.

[12] 12. HAYES, G. J. - External carotid cavernous sinus fistula. J. Neurosurg. 20:692, 1963.

[13] 13. ISAMAT, F.; SALLERAS, V. & MIRANDA, M. - Artificial embolization of carotid cavernous fistulas with postoperative patency of internal carotid artery. J. Neurol. Neurosurg. Psychiatr. 33:674, 1970.

[14] 14. KOSARY, I. Z.; LERNER, N. A.; MOZES, M. & LAZAR, M. - Artificial embolic occlusion of the internal carotid artery in the treatment of carotid cavernous fistula. J. Neurosurg. 28:605, 1968.

[15] 15. KRAYENBÜHL, H. A. & YASARGIL, M. G. - Cerebral Angiography. Butterworth & Co. London, 1968.

[16] 16. KRAYENBÜHL, H. A. - Unilateral exophthalmos. Clin. Neurosurg. 14:45, 1967.

[17] 17. KRAYENBÜHL, H. A. - Treatment of carotid cavernous fistula consisting of a one stage operation by muscle embolization of the fistulas carotid segment. In DONAGHY, R.M.P. & YASARGIL, M. G. - Microvascular Surgery, p. 151-167. C. V. Mosby e G. Thiene, Saint Louis e Stuttgart, 1967.

[18] 18. LANG, R. E. & BUCY, P. C. - Treatment of carotid cavernous fistlua by muscle embolization alone: the Brooks method. J. Neurosurg. 27:387, 1965.

[19] 19. LE XUAN TRUNG; NGUYEN THUONG XUAN & TON THAT TUNG - Traitment des fistules carotido-caverneuses par embols musculaires. Chirurgie 98:70, 1972.

[20] 20. MATTOS PIMENTA, A.; MARQUES, J. S. & BONATELLI, A. P. F. - Fistula carótido-cavernosa. Seara Médica Neurocirurgica. 1:277, 1973.

[21] 21. OBRADOR, S.; GOMEZ-BUENO, J. & RODA, E et al. - Fistulas carotido-caver-nosas. XXV Meeting Spanish-Portuguese Society of Neurosurgery. April 1973.

[22] 22. OHTA, T.; NISHIMURA, S.; KIKUCHI, H. & TOYAMA, M. - Closure of carotid fistula with polyrethane foam embolus. J. Neurosurg. 38:107, 1973.

[23] 23. PARKINSAON, D. - Carotid cavernous fistula: diret repair with preservation of the carotid artery. J. Neurosurg. 38:99, 1973.

[24] 24. PROLO, D. J. & HAMBERY, J. W. - intraluminal oclusion of a carotid-cavernous sinus fistula with a balloon catheter: technical note. J. Neurosurg. 35:237, 1971.

[25] 25. REY, A.; COPHIGNON, J.; THUREL, Cju. & THIEBAUT, J. B. - Treatment of traumatic cavernous fistulas. In KRAYENBÜHL, H., ed. - Advances and Technical Standards in Neurosurgery, vol. 2:87, 1975.

[26] 26. ROUGERIE; J.; GUILMET, D.: BAMBERGER & BOZO, C. - Anévrysme carotido-caverneux: A propôs d'une orientation thérapeutique nouvelle. Neurochirurgie. 19:649, 1973.

[27] 27. SAUNDERS, M. D. & HOYT, N. F. - Hipoxic ocular seqüelas of carotid cavernous fistulas: study of the causes of visual failure before and after neurosurgical treatment in a series of 25 cases. British J. Ophth. 53:82, 1969.

[28] 28. STROOBANDT, G.; CONNELIS, G.; DECHEF, K. & EURAND, P. - Aspects circulatoires particuliers des fistules carotido-caverneuses. Neurochirurgie. 18:333, 1972.

[29] 29. TAPTAS, J. N. - Le traitement des anévrysmes carotido-caverneux par embolization de la carótide interne cervicale. A propôs de trois cas dont un d' anévrysme carotido-caverneux bilateral, traités par embolization musculaire. Rev. Neurol. (Paris). 124:277, 1971.

[30] 30. VOIGT, K.; SAUER, M. & DICHGANS, J. - Spontaneous oclusion of a bilateral carotido-cavernous fistula studied by serial angiography. Neuroradiology. 2:207, 1971.

[31] 31. WANISSORN, R. - Mechanism of experimental muscle embolization of the carotid cavernous fistula and the fate of the emboli. J. Neurosurg. 32:344. 1970.

[32] 32. YASARGIL, M. G. - Microsurgery Applied to Neurosurgery. G. Thieme, Stuttgart, 1969.

[33] 33. ZIMMAN, J.; ZIMMAN, L. & ZIMMAN, S. - Orientacion Neuroquirurgica. Editorial Bibliográfica Omeba, S.A. 1963.