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BMJ Case Reports 2017; doi:10.1136/bcr-2017-013052
  • Case Report

Successful treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique

  1. Danial K. Hallam1,2
  1. 1Department of Radiology, University of Washington, Seattle, Washington, USA
  2. 2Department of Neurological Surgery, University of Washington, Seattle, Washington, USA
  3. 3Mechanical Engineering, University of Washington, Seattle, Washington, USA
  4. 4Philips Healthcare, Bothell, Washington, USA
  1. Correspondence to Dr Danial K Hallam, Department of Radiology, University of Washington, 325 Ninth Ave, Box 359728, Harborview Medical Center, Seattle 98104, USA; dhallam{at}uw.edu
  • Accepted 21 March 2017
  • Published 18 August 2017

Summary

We report successful transvenous treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture.

Footnotes

  • Contributors All authors contributed to the planning and study design, writing and editing the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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