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Journal of Korean Neurosurgical Society 1997;26(12): 1760-1765.
GDC(Guglielmi Detachable Coil) Embolization Used in Carotid-Cavernous Fistula Incompletely Occluded by Detachable Balloon.
Kyoung Moon Kwak, Young Joon Kim, Tae Hoon Kang, Jung Nam Sung, Hyun Koo Lee, Maeng Ki Cho
Departement of Neurosurgery, College of Medicine, Dankook University, Cheonan, Korea.
For the treatment of carotid-cavernous fistula, detachable balloon occlusion(DBO) is the method of choice. When it fails, or when the fistula is incompletely occluded, alternative treatment methods include direct surgery and internal carotid artery occlusion at the proximal and distal portion of the fistula. Before ligation or occlusion of the internal carotid artery, however, coil embolization should be considered, as this preserves patent internal carotid artery. The authors used DBO in a 22-year-old male patient with carotid-cavernous fistula which developed after head injury. During the procedures the fistula was partially obstructed by one detachable balloon. In spite of several attempted occlusions with a second balloon, this could not be introduced into the small remnant fistula hole. The second stage of intervention involved embolization with a Guglielmi detachable coil(GDC) ; this was successfully introduced into the partially obstructed fistula, which was thus completely occluded, and the patient's clinical symptoms improved. In this case, GDC emboization was an effective tool for the treatment of carotid-cavernous fistula incompletely occluded by a detachable balloon.
Key Words: Carotid-cavernous fistula; Detachable balloon occlusion; Guglielmi detachable coil(GDC); Emboilzation
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