Successful treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique

We report successful transvenous treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd...

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Bibliographic Details
Published in:BMJ case reports 2017-08, Vol.2017, p.bcr2017013052
Main Authors: Huynh, Thien J, Morton, Ryan P, Levitt, Michael R., Ghodke, Basavaraj V., Wink, Onno, Hallam, Danial K.
Format: Article
Language:English
Subjects:
Abdomen
Adult
Carotid arteries
Carotid-Cavernous Sinus Fistula - diagnostic imaging
Carotid-Cavernous Sinus Fistula - pathology
Carotid-Cavernous Sinus Fistula - therapy
Case reports
Catheters
Dissection
Ehlers-Danlos Syndrome - complications
Ehlers-Danlos Syndrome - pathology
Ehlers-Danlos Syndrome - therapy
Embolization, Therapeutic - methods
Female
Hemorrhagic Stroke
Humans
Hypertension
Magnetic Resonance Angiography - methods
Medical imaging
Mortality
Mutation
Patients
Sinuses
Tinnitus
Treatment Outcome
Vascular Surgical Procedures - methods
Veins & arteries
Work stations
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Summary:We report successful transvenous treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-013052