Endovascular treatment of a bilateral dural carotid-cavernous fistula using an unusual unilateral approach through the basilar plexus.

Background: Indirect carotid-cavernous fistulae are dural arteriovenous shunts between dural branches of the internal and/or external carotid arteries and the cavernous sinuses.

Methods: We present an uncommon case of bilateral dural carotid-cavernous fistula with aggressive angioarchitectural features that was successfully treated with bilateral coil embolization using an unusual unilateral transvenous approach through the basilar plexus.

Conclusions: This route should be considered for similar cases, and also for unilateral fistulae when the ipsilateral petrosal sinus cannot be accessed.