{
  "abstract": "Introduction A carotid-cavernous fistula (CCF) is an abnormal connection between the carotid artery and cavernous sinus, developing spontaneously or after trauma. Endovascular techniques have advanced, with treatment typically involving transarterial or transvenous approaches. In complex cases, a combination of approaches or multiple procedures may be required for optimal results.Aim of Study To describe the clinical presentation and evaluate the outcomes of endovascular treatment of CCF in a national tertiary neurosurgical center.Method A retrospective analysis was conducted on 71 patients with CCF treated using an endovascular approach at the National Center for Neurosurgery between 2008 and 2024. Clinical data were reviewed, and all patients underwent either transarterial or transvenous embolization.Results The mean age of patients was 35.7 years. According to the Barrow classification, most patients were classified as Type A (87.3%). The transarterial approach was the most commonly used (73.2%), followed by the transvenous approach in 5.6% of cases. A combined transarterial and transvenous approach was used in 1.4% of patients. Additional surgical techniques included: CCF embolization combined with ICA occlusion (16.9%), CCF occlusion via the superior ophthalmic vein approach (7%) and via the inferior petrosal sinus approach (4.2%). Periprocedural complications occurred in 4.2% of cases. Follow-up revealed complete resolution in 80.3% of patients.Conclusion Endovascular treatment of CCF is highly effective, with the majority of patients achieving complete resolution of symptoms and fistula obliteration. These findings support the safety and efficacy of endovascular therapy as a first-line treatment for CCF, particularly in cases with traumatic etiology.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Yerbol Makhambetov"
    },
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Chingiz Nurimanov"
    },
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Iroda Mammadinova"
    },
    {
      "affiliations": [
        "Faculty of Life Sciences and Medicine, King’s College London, London, UK"
      ],
      "name": "Karashash Menlibayeva"
    },
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Serik Dyussembayev"
    },
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Kunakbayev Baurzhan"
    },
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Nurtay Nurakay"
    },
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Nursultan Makhambetov"
    },
    {
      "affiliations": [
        "National Centre For Neurosurgery, Astana, Kazakhstan"
      ],
      "name": "Assylbek Kaliyev"
    }
  ],
  "title": "A192 Endovascular management of carotid-cavernous fistulas: insights from a national neurosurgical center",
  "uid": "a5c74fe3-0984-52df-8127-5182df07005c"
}