Treatment of Trapped CCF by Direct Puncture of the Cavernous Sinus by Infraocular Trans-SOF Approach. Case Report and Anatomical Basis

We present a case of recurrent carotid-cavernous fistula after prior ipsilateral carotid artery ligation. Due to lack of endovascular access, embolization was performed by direct puncture of the cavernous sinus via a transorbital approach. Operative technique and an anatomical basis for treatment are described.