Abstract 289: Hybrid Open and Endovascular Approach to Treat a Rare Case of Bilateral Carotid Cavernous Fistula

Indirect carotid‐cavernous fistulas (CCF) typically have an insidious course and may lead to serious neurological sequelae when left untreated. These include associated orbital and cerebral venous hypertension, proptosis, painful ophthalmoplegia, and vision loss. Transvenous embolization of the cavernous sinus is often the treatment of choice. Venous drainage of the fistula often dictates the ideal route to gain endovascular access to the cavernous sinus. Here, we describe a rare case of spontaneous bilateral indirect CCF treated using a hybrid approach, utilizing open surgical means for venous access and conventional endovascular technique.