TYPE-D DURAL CAROTID-CAVERNOUS FISTULA - RESULTS OF COMBINED TREATMENT WITH IRRADIATION AND PARTICULATE EMBOLIZATION

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.