Endovascular trapping of direct carotid-cavernous fistula.

We used an unconventional endovascular approach for the treatment of traumatic carotid cavernous fistula. A patient with a large high-flow shunt was successfully treated by trapping the fistula using a combination of proximal balloon occlusion and distal coil embolization. The latter was achieved following retrograde catheterization of the distal parent vessel via the ipsilateral vertebral artery.