Introduction: Despite the high rate of spontaneous resolution of Carotid Cavernous Fistulas (CCF), there are multiple therapeutic options of treatment, with variable results. Appropriate accurate diagnosis and treatment are important in the management of CCF.

Methods: Retrospective review of our database from January 2007 to January 2014, included are 30 pacientes (16 males, 14 females), of a total of 61 patients with a diagnosis of CCF. Criteria of inclusion included patients with high flow fistulas, independent of the etiology, and low flow fistulas who did not respond to non endovascular treatment. Four patients had bilateral ocular involvement.

Results: Age range was 26-88 years old, median age was 58 y/o. In 12 patients the CCF was related to trauma, and in 18 pts. Most common clinical presentations were: proptosis, conjunctival injection and pain. In 4 patients a stent was used to reconstruct the carotid artrery. Trans-arterial approach was performed in 17 patients and Trans-venous approach in 4 patients. Combined approach was done in 3 pts. Reported complications involved 2 patients, one with an inguinal hematoma and another with a transient ischemic attack.

Conclusions: Many patients with a diagnosis of Carotid Cavernous fistulas present spontaneous resolution of symptoms. Endovascular therapy is safe and effective for those patients who did not respond to conservative treatment. Stent placement can be very useful in cases when there is significant damage of the carotid artery and preservation of the carotid artery is imperative. In the trans-venous approach, there is a higher visual morbidity.

Patient Care: Standardize management protocol in our community of patients and prevent neurological complications deribadas of carotid cavernous fistulas

Learning Objectives: Describe clinical-radiologic findings in our series of patients with a diagnosis of CCF. Describe treatment options: Endovascular treatment involving the venous and arterial components. Follow the evolutuion of the lesions, complications and recurrence.

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