Embolization of Carotid Cavernous Sinus Fistula Using the Double-balloon Kick-in Technique

The use of a detachable balloon is a common and effective method for treating carotid cavernous fistula This treatment method, however, is not without risk because the balloon may not enter the cavernous sinus through the fistula, or the inflated balloon may retract into the internal carotid artery through the fistula. Under these circumstances, the internal carotid artery would have to be sacrificed to achieve therapeutic results. We present a case of embolization using the double-balloon kick-in technique, which utilizes a larger non-detachable balloon and a smaller detachable balloon. The non-detachable balloon is used to squeeze the smaller detachable balloon into the cavernous sinus through the fistula between the internal carotid artery and cavernous sinus to achieve the desired therapeutic effect.