K. Hasuo et al., TYPE-D DURAL CAROTID-CAVERNOUS FISTULA - RESULTS OF COMBINED TREATMENT WITH IRRADIATION AND PARTICULATE EMBOLIZATION, Acta radiologica, 37(3), 1996, pp. 294-298
Purpose: To assess the efficacy of irradiation combined with particula
te embolization for treating type D dural carotid-cavernous fistulas;
supplied by the meningeal branches of both external (EGA) and internal
carotid arteries. Material and Methods. Nine patients were treated by
particulate embolization via the ECA branches, followed by radiation
therapy with doses of 30 Gy. One of these patients with recurrent symp
toms received an additional 30 Gy one year after initial treatment, ma
king a total dose of 60 Gy. Results: In all cases, symptoms were impro
ved immediately after the particulate embolizations. In 8 cases, compl
ete resolution of symptoms were obtained in 4-19 months and an average
of 8 months after treatment. In one case, chemosis was markedly impro
ved and persisted minimally 41 months later. Conclusion: Particulate e
mbolization is effective for immediate symptomatic improvement, and co
mplete resolution of symptoms can usually be achieved by subsequent ra
diation therapy.