Carotid cavernous fistulas: Anatomy, classification, and treatment

In this article, we review the anatomy, classification, causes, clinical presentation, radiologic evaluation, and treatment of carotid cavernous fistulas (CCFs). CCFs are heterogeneous, with varying anatomy and causes. A precise knowledge of the anatomy and pathophysiology of each lesion is required to undertake appropriate treatment. In reviewing treatment options, we discuss direct fistulas (type A) and indirect fistulas (types B, C, D, and D2) and describe the specific methodologies required to treat each type effectively.