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Related Concept Videos

Arteries of the Head and Neck01:26

Arteries of the Head and Neck

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The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
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The coronary arteries, originating from the ascending aorta, bifurcate from two sinuses located within the ascending aorta. Positioned just above the aortic semilunar valve, these sinuses house essential aortic baroreceptors and chemoreceptors, crucial for maintaining cardiac function. The left coronary artery and the right coronary artery branch off from the left posterior and anterior aortic sinuses, respectively.
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Related Experiment Video

Updated: Jul 21, 2025

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
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Direct Carotid Cavernous Fistulas.

Satomi Ide1, Hiro Kiyosue1, Kohei Tokuyama1

  • 1Department of Radiology, Oita University Faculty of Medicine, Yufu, Oita, Japan.

Journal of Neuroendovascular Therapy
|July 28, 2023
PubMed
Summary

Direct carotid cavernous fistulas (CCF) are treated with endovascular therapy. Techniques like detachable coils and adjunctive methods are used to close the abnormal shunts while preserving the internal carotid artery (ICA).

Keywords:
coil embolizationdetachable balloondirect carotid cavernous fistulatransarterial embolizationtransvenous embolization

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Direct carotid cavernous fistula (CCF) involves abnormal shunting between the internal carotid artery (ICA) and cavernous sinus (CS).
  • Traumatic CCF constitutes up to 75% of all cases.
  • Endovascular therapy is the established standard for managing direct CCF.

Purpose of the Study:

  • To outline the necessary evaluations for successful endovascular treatment of direct CCF.
  • To discuss various endovascular tools and techniques for CCF management.
  • To highlight considerations for preserving the ICA during treatment.

Main Methods:

  • Cerebral angiography is crucial for evaluating fistula characteristics and ICA occlusion tolerance.
  • 3D rotational angiography with multi-planner reformatted images aids precise visualization.
  • Endovascular treatment primarily utilizes detachable coils, with adjunctive balloon- and stent-assisted techniques for complex cases.

Main Results:

  • Detachable coils are preferred due to availability, retrievability, and control.
  • Adjunctive techniques are often necessary for large or multiple fistulas.
  • Selective embolization is vital to prevent cranial nerve palsy.

Conclusions:

  • Endovascular therapy offers effective management for direct CCF.
  • Technique selection depends on fistula anatomy, hemodynamics, and operator expertise.
  • Parent artery occlusion (PAO) is considered when ICA preservation is not feasible.