PT  - JOURNAL ARTICLE
AU  - Tsai, Y.-H.
AU  - Wong, H.-F.
AU  - Weng, H.-H.
AU  - Chen, Y.-L.
TI  - Comparison of the Risk of Oculomotor Nerve Deficits between Detachable Balloons and Coils in the Treatment of Direct Carotid Cavernous Fistulas
AID  - 10.3174/ajnr.A2009
DP  - 2010 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1123--1126
VI  - 31
IP  - 6
4099  - http://www.ajnr.org/content/31/6/1123.short
4100  - http://www.ajnr.org/content/31/6/1123.full
SO  - Am. J. Neuroradiol.2010 Jun 01; 31
AB  - BACKGROUND AND PURPOSE: Transarterial balloon embolization used to be the preferred method for treating DCCFs; however, a strayed, overinflated, or migrated balloon may lead to oculomotor palsy. This investigation compared the use of detachable balloons and GDCs, which were previously used only in cases of balloon-technique failure and are now increasingly used as a first-line treatment for DCCFs, in terms of the risk of oculomotor nerve deficit, mortality/morbidity, and initial angiographic results. MATERIALS AND METHODS: Among 48 patients with DCCFs treated with endovascular embolization at our institution between March 2004 and May 2009, 38 patients were included in this review. Patients who underwent trapping procedures, a second intervention within 2 weeks, or any procedure that included n-BCA infusion were excluded. Twenty of the enrolled patients were treated with transarterial balloons and the other 18, with GDCs. RESULTS: Five patients (25%) in the balloon group and none in the coil group had oculomotor nerve deficits within 2 weeks. The rate of procedure-related oculomotor nerve deficit was significantly higher in the balloon group than in the coil group (P = .048). There were no significant differences in terms of procedure-related mortality/morbidity or initial angiographic results between the 2 groups. CONCLUSIONS: The risk of procedure-related oculomotor nerve deficit in the treatment of DCCFs was significantly lower when using a GDC than with a detachable balloon. GDCs may, therefore, be considered as feasible, effective, and safe for DCCFs as detachable balloons. CScavernous sinusDCCFdirect carotid cavernous sinus fistulaGDCGuglielmi detachable coilICAinternal carotid arteryn-BCAn-butyl cyanoacrylate