• Jung Yong Ahn, Young Sun Chung, Byung Hee Lee, Sung Wook Choi, and Ok Jun Kim.
• Department of Neurosurgery, Pundang CHA Hospital, Pochon CHA University, Yatap-dong, Pundang-gu, Sungnam, South Korea. jyahn@cha.ac.kr
• J Clin Neurosci. 2004 Aug 1; 11 (6): 636-9.

AbstractTraumatic arteriovenous fistulas following carotid artery injuries are rare. Treatment of carotid artery-to-jugular vein fistula requires direct closure of the fistula or occlusion of the carotid artery above and below the level of the fistula, by a surgical or endovascular approach. A 32-year-old man presented with a right-sided pulsatile neck swelling 2 days following a stab wound. Neck computed tomography demonstrated a vascular mass protruding into the anterior neck. Digital subtraction arteriography demonstrated a bilobular large internal carotid artery pseudoaneurysm just distal to its bifurcation. There was simultaneous opacification of a dilated left internal jugular vein indicating a high-flow internal carotid-internal jugular fistula. A balloon-expandable stent-graft was delivered and successfully positioned across the fistula. The arteriovenous fistula and pseudoaneurysm completely disappeared and the right internal carotid artery was well preserved. The stent-graft is a promising technology to obliterate fistulae and preserve the parent artery with relative safety.

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