Abstract
Many reports have been presented on the treatment of spontaneous carotid cavernous fistula (SCCF). However, treatment of SCCF is controversially. We reported three cases of SCCF. The first case was a 57-year-old female. Right carotid angiography demonstrated low flow CCF and Type B on classification by Barrow. SCCF disappeared by Matas manuever only. The second case was a 62-year-old woman. Bilateral carotid angiography showed low flow CCF and Type D by Barrow. CCF disappeared by Matas manuever, embolization and ligation of left external carotid artery. The third case was a 66-year-old woman. Bilateral carotid angiography revealed high flow CCF and Type D reported by Barrow. Treatments were Matas manuever and transvenous embolization. Embolization was performed by using platinum microcoils through internal jugular vein, inferior petrous vein to cavernous sinus. In summary, we believe that the first step of SCCF treatment is Matas manuever in 2-4 weeks and if unsuccessfully, tranvenous embolization is performed. With improvement of technology in minicatheters and embolic materials, transvenous embolization should be considered as one of the most effective, safest method for SCCF.
