Application of flat-panel digital subtraction angiography in interventional therapy for carotid cavernous fistutas:initial clinical experience

Objective To assess the clinical value offlat-panel digital subtraction angiography (DSA)in interventional therapy for carotid-cavemous fistula (CCF). Methods Three-dimensional (3D)DSA Was performed in 12 patients with CCF before the interventional therapy.The fistular orifice was located and measured with multiplanar reconstruction technique,and the Landscap roadmap of the fistula was obtained.Fistula embolization was performed according to the location of the fistular orifice and the surrounding bony marker indicated by 3D and Landscap roadmap. Results The fistular orifices were clearly displayed in the 12 patients with an average orifice diameter of 3.7 mm.The intemal carotid artery(ICA)and the bony marker of the cavernous sinus were shown simultaneously.Ten patients received endovascular embolization wiith detachable balloon, and 1 patient was treated wiith coil and 1 with stent placement.The ICA remained patent in 11 cases and carotid artery occlusion was performed in 1 case. Conclusion The 3D flat-panel DSA provides rich infolrmati,Ion on the fistular orifice,,and the bony markers can be identified by landscape roadmap technique..The combination of these two techniques guarantees effective and safe treatment of CCE. Key words: Carotid-cavernous fistulas; Embolization,therapeutic; Imerventional radiology