Carotid Cavernous Fistula (CCF) on Angiography Left External carotid injection shows an indirect Carotid-cavernous fistula filling through ECA branches. Carotid-cavernous fistulas are abnormal vascular shunts, allowing blood to flow either directly or indirectly from the carotid artery into the cavernous sinus. Direct CCFs arise directly from the carotid artery, while indirect CCFs originate from carotid artery branch vessels. Dr. Boby Varkey Maramattom @bobvarkey #Carotid #Cavernous #Fistula #CCF #Angiography #Cerebral #fluoroscopy #clinical #neurology #neuroradiology