Application of the Willis Covered Stent in the Treatment of Carotid-Cavernous Fistula: A Single-Center Experience.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York : Elsevier
    • Subject Terms:
      Blood Vessel Prosthesis* ; Stents*; Carotid-Cavernous Sinus Fistula/*surgery ; Endovascular Procedures/*methods; Adolescent ; Adult ; Carotid-Cavernous Sinus Fistula/diagnosis ; Carotid-Cavernous Sinus Fistula/epidemiology ; China/epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult
    • Abstract:
      Background: The purpose of the present study was to describe our single-institutional experience of treating direct carotid-cavernous fistulas (DCCFs) with Willis covered stents (WCSs).
      Methods: Of a total of 31 DCCFs, 10 were treated with WCSs (Microport, Shanghai, China) at West China Hospital from January 2015 to December 2016. The indications for treatment, perioperative findings, and postoperative and follow-up results were collected and analyzed.
      Results: All 10 patients had successful deployment of WCSs. Complete exclusion of the fistula was achieved in 6 patients immediately after deployment of 1 stent. Endoleak was observed in 4 patients (patients 2, 4, 5, and 9). Thus, repeat dilation of the stent with greater pressure was performed, which resolved the endoleak in 2 patients (patients 2 and 9). The endoleak of the other 2 patients persisted after repeat dilation of the balloon. Hence, a second stent was deployed in these 2 patients (patients 4 and 5), which eliminated the endoleak in patient 4. However, patient 5 continued to have a minimal endoleak. Nine patients had fistulas successfully occluded by WCSs during the follow-up period. One patient experienced recurrence of a DCCF at the 10-day follow-up point. We chose coil embolization to address this DCCF. No stenosis of the internal carotid artery or DCCF recurrence, except that in the abovementioned patient, was observed.
      Conclusions: WCS was proved to be an alternative treatment method for complex DCCFs through reconstruction and preservation of the internal carotid artery. Our study also confirmed the safety, efficacy, and midterm durability of WCSs for complex DCCFs without any serious delayed complications.
      (Copyright © 2018 Elsevier Inc. All rights reserved.)
    • Contributed Indexing:
      Keywords: Carotid–cavernous fistula; Complication; Covered stent; Endovascular
    • Publication Date:
      Date Created: 20181024 Date Completed: 20190221 Latest Revision: 20190221
    • Publication Date:
      20240829
    • Accession Number:
      10.1016/j.wneu.2018.10.060
    • Accession Number:
      30352308