Article Figures & Data
Figures
- fig 1.
63-year-old man with a CCF and an ipsilateral ICA dissection.
A, Anteroposterior view of the right common carotid artery injection shows a spiral flap within the cervical ICA (straight arrow). Early opacification (curved arrow) of the cavernous sinus indicates the presence of a CCF.
B, Lateral view of the right ICA (treatment day 2) shows that the CCF is completely reopened. Artifact from the gold marker of the deflated latex balloon (straight white arrow) indicates that the balloon has not moved but is situated close to the carotid artery. The dissection flap of the ICA is well seen on this projection (curved white arrow). The inferior petrosal sinuses (black arrow) opacify promptly, indicating ease of transvenous access to the cavernous sinus via this route.
C, Lateral projection of a still image taken during coil deployment in the cavernous sinus. The Endeavor balloon (straight arrow) is inflated across the laceration of the ICA. A number of fibered and nonfibered GDCs have been deployed within the cavernous sinus via a two-marker microcatheter. The coils are beginning to assume a complex disposition in a 3D configuration around the ICA. The marker of the balloon catheter (curved white arrow) and the proximal marker of the double-marker microcatheter (curved black arrow) lie close together but within different anatomic structures, the ICA and inferior petrosal sinus, respectively.
D and E, Anteroposterior (D) and lateral (E) views of the right ICA injection after complete occlusion of the CCF with coils. The complex disposition of the coils (arrows) within the cavernous sinus denies a profile view of the carotid artery. Use of the nondetachable balloon within the arterial lumen during coil deployment preserved the integrity of the arterial lumen and prevented inadvertent compromise of the artery.
