Carotid-cavernous fistula: closure with detachable silicone balloons.

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Abstract
Detachable silicone rubber balloons, which do not require an outer catheter to effect detachment, were used to close carotid-cavernous fistulas in 10 patients. Closure was effective in 9 of 10 patients. The internal carotid artery was intentionally occluded in 2 patients. The procedure resulted in inadvertent occlusion of the internal carotid artery in 3 patients. Follow-up studies showed no recurrence of the fistula; nor did any permanent neurologic deficits develop as a result of the procedure. The balloon catheter system and techniques of introduction are discussed in detail. The system is compared with other silicone and latex balloon systems that require a coaxial catheter for detachment. Technical and clinical problems are illustrated.