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Hemorrhagic stroke
Case report
Republished: 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
  1. Thien J Huynh1,
  2. Ryan P Morton2,
  3. Levitt Michael R.1,3,
  4. Basavaraj V. Ghodke1,2,
  5. Onno Wink4,
  6. Danial K. Hallam1,2
  1. 1Department of Radiology, University of Washington, Seattle, Washington, USA
  2. 2Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
  3. 3Mechanical Engineering, University of Washington, Seattle, Washington, USA
  4. 4Philips Healthcare, Bothell, Washington, USA
  1. Correspondence to Danial K. Hallam, Department of Radiology, University of Washington, Harborview Medical Center, Seattle, WA 98104, USA; dhallam{at}uw.edu

Abstract

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.

  • fistula
  • technique
  • navigation
  • intervention
  • magnetic resonance angiography

http://dx.doi.org/10.1136/neurintsurg-2017-013052.rep

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    Footnotes

    • Contributors All authors contributed to the planning and study design, writing and editing the manuscript.