• Yoshiro Ito, Tetsu Satow, Hirofumi Matsubara, Hiroharu Kataoka, and Jun C Takahashi.
• Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. Electronic address: yoshiro@md.tsukuba.ac.jp.
• World Neurosurg. 2019 Feb 1; 122: 123-128.

BackgroundVascular Ehlers-Danlos syndrome (vEDS) is a vascular disease associated with a genetic collagen abnormality. It is characterized by vessel fragility, vessel rupture, and massive hemorrhage. Carotid-cavernous fistula (CCF) is the most frequent neurovascular complication of vEDS. However, CCF treatment using conventional diagnostic angiography and neuroendovascular therapy can result in a high rate of major complications.Case DescriptionWe report a case of a right CCF in a 48-year-old man with vEDS. The carotid artery and jugular vein were exposed by direct neck dissection. To avoid systemic vascular complications, multiple catheters were inserted into the shunt segment via the carotid artery and jugular vein. This transarterial and transvenous multidevice technique enabled compact placement of coils in the shunt segment. The CCF was eliminated via selective shunt occlusion. Postoperative magnetic resonance imaging revealed occlusion of the right CCF.ConclusionsSelective shunt occlusion via a transarterial and transvenous multidevice technique is a useful and safe approach for treating vEDS-associated CCF.Copyright © 2018 Elsevier Inc. All rights reserved.

15 keywords...

hide…