[Treatment of a Traumatic Direct Carotid Cavernous Fistula with an Intradural Internal Carotid Artery Pseudoaneurysm Using a Low-profile Visualized Intraluminal Support(LVIS)Stent:A Case Report]

No Shinkei Geka. 2018 Nov;46(11):989-997. doi: 10.11477/mf.1436203853.
[Article in Japanese]

Abstract

Traumatic carotid cavernous fistula(CCF)is known to present a direct connection between the cavernous segment of the internal carotid artery(ICA)and the cavernous sinus(CS). In rare cases, the fistula is formed between the intradural internal carotid artery(ICA)and the cavernous sinus(CS)via a pseudoaneurysm(pAN), requiring appropriate management and aggressive surgical treatment. We describe a 58-year-old man who sustained a severe head injury diagnosed as traumatic CCF treated with an intradural pAN procedure and transarterial coil embolization combined with a Low-profile Visualized Intraluminal Support(LVIS)stent. While slow arteriovenous shunt flow persisted at the end of the surgery, the fistula was completely occluded on the digital subtraction angiography obtained 2 weeks after the procedure. It was suspected that the flow-diversion effect of the LVIS stent might have caused the curable progression of the fistula occlusion.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False* / diagnosis
  • Aneurysm, False* / therapy
  • Carotid Artery, Internal
  • Carotid-Cavernous Sinus Fistula* / diagnosis
  • Carotid-Cavernous Sinus Fistula* / therapy
  • Cavernous Sinus*
  • Cerebral Angiography
  • Embolization, Therapeutic*
  • Humans
  • Male
  • Middle Aged
  • Stents