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KMID : 1005420220240040356
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Journal of Cerebrovascular and Endovascular Neurosurgery
2022 Volume.24 No. 4 p.356 ~ p.365
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Carotid cavernous fistula: Redefining the angioarchitecture
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Mishra Keshav
Kumar Vivek
Vinay
Gandhi Ashok
Srivastava Trilochan
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Abstract
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Objective : Numerous classification schemes have been used for carotid cavernous fistula (CCF), each describing some aspect of the disease process but none of them provides a complete description of the fistula including its clinical features, natural history, arterial and venous architecture.
Methods : Retrospective clinical and radiological review was done for all the patients diagnosed with CCF and treated at our institute. The CCF were classified according to the proposed API-ACE classification along with Barrow and Thomas classification.
Results : Overall 28 patients (M=21, F=7) were diagnosed and treated during the 6-year period. 89.2% of CCF developed following an episode of head injury. Orbital symptoms were the most common presenting complaints. Barrows type A was the most predominant subtype (n=24) and most of the patients (n=23) demonstrated decreased ipsilateral carotid filling. Combined anterior and posterior drainage pattern was the most common drainage pattern and anterior drainage was more commonly observed than posterior drainage.
Conclusions : API-ACE classification helps to better understand and classify the angioarchitecture of CCF which could help better understand the clinical manifestations and guide in appropriate endovascular approach selection for treatment.
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KEYWORD
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Carotid cavernous fistula (CCF), Thomas classification, Venous angioarchitecture
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