Background Post-traumatic carotid cavernous fistula (CCF) type A is a high-flow vascular disorder that often presents with orbital symptoms due to venous congestion. Endovascular treatment is the mainstay therapy; however, the impact of coiling intensity on clinical recovery remains unclear. Objective To evaluate the effect of coiling intensity on clinical recovery in patients with post-traumatic CCF type A. Methods This retrospective analytical study was conducted at a single tertiary center in Indonesia between 2020 and 2025. Patients with post-traumatic CCF type A who underwent endovascular treatment were included. Subjects were categorized into non-to-minimal coiling (≤1 coil) and optimal coiling (≥2 coils) groups. Clinical characteristics, including proptosis, chemosis, conjunctival redness, bruit, blurred vision, and orbital pain, were assessed before and after intervention. Recovery time to clinical resolution was also evaluated. Statistical analysis was performed using the McNemar test and Fisher's exact test, with a significance level of p < 0.05. Results Patients undergoing optimal coiling demonstrated significantly shorter recovery times to clinical resolution compared to those with non-to-minimal coiling ( p = 0.022). Significant improvements were observed in proptosis, conjunctival redness, and chemosis. In contrast, blurred vision, orbital pain, and bruit did not show statistically significant differences between groups. Conclusions Optimal coiling was associated with faster clinical recovery and better resolution of venous congestion-related symptoms in post-traumatic CCF type A. These findings highlight the importance of achieving adequate fistula occlusion in improving clinical outcomes.
Negara et al. (Mon,) studied this question.