Endovascular treatment of a traumatic carotid cavernous

World Neurosurg · May 2023

Case Reports

Endovascular treatment of a traumatic carotid cavernous fistula concomitant with intracranial pseudoaneurysm by flow diverter, 2-dimensional operative video.

Traumatic carotid cavernous fistulas (TCCFs) and traumatic intracranial pseudoaneurysms are uncommon vascular anomalies associated with head trauma.1,2 Detachable balloons, covered stents, or liquid embolic agents can be used to treat TCCFs in some conditions.3,4 TCCF concomitant with pseudoaneurysm is an extremely rare occurrence in the literature.5,6 In Video 1, we present a unique case of a TCCF concomitant with a giant pseudoaneurysm of the posterior communicating segment of the left internal carotid artery in a young patient. Both lesions were successfully managed with an endovascular treatment using a Tubridge flow diverter (MicroPort Medical Company, Shanghai, China), coils, and Onyx 18 (Medtronic, Bridgeton, Missouri, USA). ⋯ This video shows a new treatment method for TCCF concomitant with a pseudoaneurysm. The patient consented to the procedure.

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- Yihui Ma, Zejin Li, and Wenyuan Zhao.
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
- World Neurosurg. 2023 May 1; 173: 9595.
AbstractTraumatic carotid cavernous fistulas (TCCFs) and traumatic intracranial pseudoaneurysms are uncommon vascular anomalies associated with head trauma.1,2 Detachable balloons, covered stents, or liquid embolic agents can be used to treat TCCFs in some conditions.3,4 TCCF concomitant with pseudoaneurysm is an extremely rare occurrence in the literature.5,6 In Video 1, we present a unique case of a TCCF concomitant with a giant pseudoaneurysm of the posterior communicating segment of the left internal carotid artery in a young patient. Both lesions were successfully managed with an endovascular treatment using a Tubridge flow diverter (MicroPort Medical Company, Shanghai, China), coils, and Onyx 18 (Medtronic, Bridgeton, Missouri, USA). No neurologic complications occurred due to the procedures. Six-month follow-up angiography illustrated complete resolution of fistula and pseudoaneurysm. This video shows a new treatment method for TCCF concomitant with a pseudoaneurysm. The patient consented to the procedure.Copyright © 2023 Elsevier Inc. All rights reserved.

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Endovascular treatment of a traumatic carotid cavernous fistula concomitant with intracranial pseudoaneurysm by flow diverter, 2-dimensional operative video.

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