Treatment of post-traumatic carotid-cavernous fistulas with the Willis covered stent. A preliminary prospective study

Interv Neuroradiol. 2012 Jun;18(2):172-7. doi: 10.1177/159101991201800208. Epub 2012 Jun 4.

Abstract

We describe our preliminary experience on the feasibility of using the Willis covered stent in patients with carotid-cavernous fistulas (CCFs). Eleven consecutive patients with post-traumatic CCFs referred for treatment with Willis covered stents were enrolled into this prospective study, and were subsequently followed-up at our hospital. Data on technical success, initial and final angiographic results, mortality, morbidity and final clinical outcome, was collected, with follow-up performed at one, three, six and 12 months, and yearly thereafter. Deployment of the covered stents was technically successful in all patients. Angiographic results following stent placement showed a complete occlusion in eight patients with ten CCFs, and an incomplete occlusion in three. No adverse events occurred either during or after the procedure. Angiographic follow-up (mean 14.73 ± 6.77 months) revealed complete occlusion and no obvious in-stent stenosis in all patients. Clinical follow-up (mean 17.73 ± 6.48 months) demonstrated full recovery in ten patients, and improvement in one. These preliminary results indicate that the use of the Willis covered stent is a feasible procedure, and that it may therefore serve as an alternative treatment for CCFs. Longer follow-up assessments and an expanded clinical trial are needed.

MeSH terms

  • Adolescent
  • Adult
  • Carotid-Cavernous Sinus Fistula / diagnostic imaging
  • Carotid-Cavernous Sinus Fistula / etiology
  • Carotid-Cavernous Sinus Fistula / surgery*
  • Cerebral Angiography
  • Coated Materials, Biocompatible
  • Craniocerebral Trauma / complications*
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography, Interventional
  • Stents*
  • Treatment Outcome

Substances

  • Coated Materials, Biocompatible