Historical Treatment of Carotid Cavernous Fistula (.pdf)

CCA (Common Carotid Artery) ligation was a commonplace procedure throughout the 19th century and was first used in CCSF (Carotid-Cavernous Sinus Fistula) after it became evident that carotid artery compression reduced pulsating exophthalmos. The first description of ICA (Internal Carotid Artery) ligation for CCSF followed in 1904. Carotid artery ligation continued to be the mainstay of treatment until the introduction of balloon occlusion of the fistula in the early 1970s. While often effective in reducing symptoms and preventing the most severe complications, ICA ligation has usually not been successful in eliminating all shunt related clinical manifestations.