Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up

Abstract Background Willis covered stent is the first stent designed exclusively for intracranial vasculature, and its application in carotid-cavernous fistula is limited. The aim is to evaluate the feasibility and efficacy of this device in treating direct carotid-cavernous fistula. Methods Ten con...

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Main Authors: Qinglin Liu, Changjing Qi, Yunyan Wang, Wandong Su, Gang Li, Donghai Wang
Format: Article
Language:English
Published: BMC 2021-09-01
Series:Chinese Neurosurgical Journal
Subjects:
Online Access:https://doi.org/10.1186/s41016-021-00256-y
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author Qinglin Liu
Changjing Qi
Yunyan Wang
Wandong Su
Gang Li
Donghai Wang
author_facet Qinglin Liu
Changjing Qi
Yunyan Wang
Wandong Su
Gang Li
Donghai Wang
author_sort Qinglin Liu
collection DOAJ
description Abstract Background Willis covered stent is the first stent designed exclusively for intracranial vasculature, and its application in carotid-cavernous fistula is limited. The aim is to evaluate the feasibility and efficacy of this device in treating direct carotid-cavernous fistula. Methods Ten consecutive patients with direct carotid-cavernous fistula were treated in our institution with Willis covered stents from September 2013 to December 2015. The characteristics of these patients and the immediate and follow-up results were retrospectively reviewed. Results Of the 10 patients, 8 were treated for the first time, and 2 had been treated elsewhere. Willis covered stents were successfully released in 9 patients. Abnormal arteriovenous shunt disappeared in 6 cases immediately after stent deployment and endoleak occurred in 3 cases. Endoleak disappeared at 6-month angiography follow-up in one case and was sealed with coils through a pre-set microcatheter in another case. Parent artery was sacrificed as endoleak remained despite repeated balloon dilation and a second stent deployment in the third case. All patients got clinical follow-ups for at least 24 months and 7 patients received angiographic follow-up. Symptoms were relieved gradually in all cases except for slight oculomotor paralysis and visual acuity in one case, respectively. In-stent stenosis was found in 1 case, and no recurrence was observed. Conclusions Willis covered stent is feasible for direct carotid-cavernous fistula.
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spelling doaj.art-30861079d182486f8c12f8542cda3eda2022-12-21T18:43:43ZengBMCChinese Neurosurgical Journal2057-49672021-09-01711810.1186/s41016-021-00256-yTreatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-upQinglin Liu0Changjing Qi1Yunyan Wang2Wandong Su3Gang Li4Donghai Wang5Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversitysNursing Department of Qilu Hospital, Shandong UniversityNeurosurgery Department of Qilu Hospital, Shandong UniversityNeurosurgery Department of Qilu Hospital, Shandong UniversityNeurosurgery Department of Qilu Hospital, Shandong UniversityNeurosurgery Department of Qilu Hospital, Shandong UniversityAbstract Background Willis covered stent is the first stent designed exclusively for intracranial vasculature, and its application in carotid-cavernous fistula is limited. The aim is to evaluate the feasibility and efficacy of this device in treating direct carotid-cavernous fistula. Methods Ten consecutive patients with direct carotid-cavernous fistula were treated in our institution with Willis covered stents from September 2013 to December 2015. The characteristics of these patients and the immediate and follow-up results were retrospectively reviewed. Results Of the 10 patients, 8 were treated for the first time, and 2 had been treated elsewhere. Willis covered stents were successfully released in 9 patients. Abnormal arteriovenous shunt disappeared in 6 cases immediately after stent deployment and endoleak occurred in 3 cases. Endoleak disappeared at 6-month angiography follow-up in one case and was sealed with coils through a pre-set microcatheter in another case. Parent artery was sacrificed as endoleak remained despite repeated balloon dilation and a second stent deployment in the third case. All patients got clinical follow-ups for at least 24 months and 7 patients received angiographic follow-up. Symptoms were relieved gradually in all cases except for slight oculomotor paralysis and visual acuity in one case, respectively. In-stent stenosis was found in 1 case, and no recurrence was observed. Conclusions Willis covered stent is feasible for direct carotid-cavernous fistula.https://doi.org/10.1186/s41016-021-00256-yFistulaEndovascular proceduresStentsEndoleak
spellingShingle Qinglin Liu
Changjing Qi
Yunyan Wang
Wandong Su
Gang Li
Donghai Wang
Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up
Chinese Neurosurgical Journal
Fistula
Endovascular procedures
Stents
Endoleak
title Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up
title_full Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up
title_fullStr Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up
title_full_unstemmed Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up
title_short Treatment of direct carotid-cavernous fistula with Willis covered stent with midterm follow-up
title_sort treatment of direct carotid cavernous fistula with willis covered stent with midterm follow up
topic Fistula
Endovascular procedures
Stents
Endoleak
url https://doi.org/10.1186/s41016-021-00256-y
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