%0 Review
%T Direct puncture the superior ophthalmic vein guiding by Dyna-CT to obliterating a traumatic carotid-cavernous sinus fistula: A case report and literature review.
%A Min XF
%A Yuan G
%A Si GY
%A Xu YN
%J Medicine (Baltimore)
%V 101
%N 43
%D Oct 2022 28
%M 36316851
%F 1.817
%R 10.1097/MD.0000000000031560
%X <B>BACKGROUND: </B>Traumatic carotid-cavernous sinus fistula (TCCF) is a pathological shunt between the carotid arteries and cavernous sinus due to trauma. Imaging-guided (e.g., ultrasonic image and fluoroscopic roadmap image) direct puncture of the superior ophthalmic vein (SOV) for embolization of TCCF has been previously described in other studies.<BR><B>METHODS: </B>We report a case of TCCF in a 58-years-old male patient who was admitted to our hospital with a sustained head injury after falling from a high platform, resulting in rapidly progressive swelling, pain, diminishing vision for more than 6 months, and blindness in his left eye for 1 month.<BR><B>RESULTS: </B>The patient underwent digital subtraction angiography and endovascular embolization. After the failure of super-selection of the left cavernous sinus, an alternative approach to obliterating the TCCF by puncturing the SOV is directly guided by Dyna-CT. After embolization, the patient's clinical symptoms gradually disappeared and discharged from the hospital 5 days later. No recurrence or complications occurred during follow-up for 1 year.<BR><B>CONCLUSIONS: </B>This case illustrates that direct puncture of the SOV guided by Dyna-CT as an alternative approach to embolization of TCCF is safe, effective, and feasible.