Transradial Comaneci-assisted coiling of a direct carotid-cavernous fistula

Roger Barranco Pons, MD; Valerio Da Ros, MD; Jacopo Scaggiante, MD; Greicy Muniz da Silva, MD; Eliseo Picchi, MD; Francesca Di Giuliano, MD; Lucia Aja Rodriguez, MD; Oscar Chirife Chaparro, MD

Radiology Case Reports (Dec 2019)

Transradial Comaneci-assisted coiling of a direct carotid-cavernous fistula

Roger Barranco Pons, MD,
Valerio Da Ros, MD,
Jacopo Scaggiante, MD,
Greicy Muniz da Silva, MD,
Eliseo Picchi, MD,
Francesca Di Giuliano, MD,
Lucia Aja Rodriguez, MD,
Oscar Chirife Chaparro, MD

Affiliations

Roger Barranco Pons, MD: Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain
Valerio Da Ros, MD: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy
Jacopo Scaggiante, MD: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy; Corresponding author.
Greicy Muniz da Silva, MD: Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain
Eliseo Picchi, MD: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy
Francesca Di Giuliano, MD: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford, 8100133 Rome, Italy
Lucia Aja Rodriguez, MD: Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain
Oscar Chirife Chaparro, MD: Department of Interventional Neuroradiology, Bellvitge University Hospital, C/Feixa Llarga s/n 08017. Hospitalet de Llobregat, Barcelona, Spain

Journal volume & issue: Vol. 14, no. 12
pp. 1554 – 1557

Abstract

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Direct carotid-cavernous fistula is a communication between the internal carotid artery and the cavernous sinus, most of the times established following trauma or rupture of a cavernous aneurysm. The most commonly used treatments (coils, detachable latex balloons, stents, or liquid agents) carry ischemic or hemorrhagic risks, related to hemodynamic diversion of cerebral blood flow or permanent dual antiplatelet therapy. We report a case of coiling of a carotid-cavernous fistula assisted by the Comaneci, a temporary adjustable bridging mesh (Rapid Medical, Israel), to avoid transarterial or -venous migration. In our experience, Comaneci-assisted coiling represents a feasible solution to maintain patency of the distal vessels during coiling and avoid dual antiplatelet medications, even using a transradial approach. Keywords: Radial access, Comaneci, Direct carotid-cavernous fistula, Embolization, Stent

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: http://www.journals.elsevier.com/radiology-case-reports/

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