Carotid-cavernous fistula. Intravascular treatment with a self-sealing detachable balloon

Five traumatic carotid-cavernous fistulas were treated using a new self-sealing, detachable, silicone-rubber balloon, as part of a balloon-catheter system, and a modified technique for positioning the balloon. The fistulas were occluded successfully in four patients; in a fifth patient, a small fistula persisted. In each instance, the internal carotid artery flow was preserved. The flexible balloon-catheter system can be guided via the blood flow and still not require a coaxial catheter for detachment. Moreover, the flexibility of the balloon and catheter resulted in easy positioning through a tortuous internal carotid artery.