Robotic-guided direct transtemporal embolization of an indirect carotid cavernous fistula

Patrick J. Karas, Jae Eun Lee, Thomas S. Frank, Frances Tiffany Morden, Hashem Shaltoni, Peter Kan

Research output: Contribution to journalArticlepeer-review


A middle-aged patient presented with right-sided chemosis, exophthalmos, and progressive visual loss. Digital subtraction angiography revealed a type D carotid-cavernous fistula (CCF). Transarterial embolization through the internal maxillary artery was unsuccessful, and there was no venous access to the CCF. A robotic-guided direct transtemporal embolization of the CCF with Onyx was performed, resulting in successful fistula obliteration and symptom resolution. This is the first reported case of a robotic-guided direct transcranial CCF embolization. We include a technical video that demonstrates this procedure (Supplemental File 1).

Original languageEnglish (US)
Pages (from-to)1122-1123
Number of pages2
JournalJournal of neurointerventional surgery
Issue number11
StatePublished - Nov 1 2023


  • Balloon
  • Fistula
  • Liquid Embolic Material
  • Technique
  • Vascular Malformation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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