Traumatic carotid—cavernous fistula treated by combined transarterial and transvenous coil embolization and associated cavernous internal carotid artery dissection treated with stent placement

2003 ◽  
Vol 99 (3) ◽  
pp. 584-586 ◽  
Author(s):  
Süleyman Men ◽  
Halil Öztürk ◽  
Baki HekimoğLu ◽  
Zeki Şekerci
Keyword(s):  
Carotid Artery ◽  
Stent Placement ◽  
Coil Embolization ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula

✓ The authors report on a case in which a carotid—cavernous fistula and an associated cavernous—carotid dissection developed in a 48-year-old man following a motor vehicle accident. The fistula was treated with coil embolization via a combined transarterial—transvenous approach. The dissected carotid artery segment was treated with a balloon-expandable stent, which restored normal caliber and hemispheric flow. There was no recurrence of the fistula and the postoperative wide patency of the carotid artery indicates that stent placement is an effective method of treating traumatic intracranial artery dissections.

Traumatic Carotid Artery Dissection and Pseudoaneurysm Treated with Endovascular Coils and Stent

1997 ◽  
Vol 4 (4) ◽  
pp. 339-343 ◽  
Author(s):  
John H. Matsuura ◽  
David Rosenthal ◽  
Hilde Jerius ◽  
Michael D. Clark ◽  
David S. Owens
Keyword(s):  
Carotid Artery ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Carotid Dissection ◽  
Pseudoaneurysm Formation ◽  
Vehicle Accident ◽  
Detachable Coils ◽  
Base Of The Skull

Purpose: To report a case of post-traumatic internal carotid artery dissection and pseudoaneurysm formation at the C-1 level successfully treated by a percutaneous endovascular technique. Methods and Results: A 20-year-old female presented 72 hours after a motor vehicle accident with incomplete occulosympathetic paresis (Horner's syndrome), carotidynia, and left-sided weakness. Arteriography confirmed the diagnosis of carotid dissection and an associated 1.5-cm × 2.5-cm pseudoaneurysm at the C-1 level. Neuroradiologists embolized the pseudoaneurysm with Guglielmi detachable coils and controlled the dissection with placement of a Wallstent. Conclusions: This report illustrates successful percutaneous endovascular treatment of a carotid dissection and pseudoaneurysm near the base of the skull.

Intracranial stent placement for the treatment of a carotid—cavernous fistula associated with intracranial angioplasty

2003 ◽  
Vol 98 (5) ◽  
pp. 1116-1119 ◽  
Author(s):  
Stanley H. Kim ◽  
Adnan I. Qureshi ◽  
Alan S. Boulos ◽  
Bernard R. Bendok ◽  
Elad I. Levy ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
High Grade ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Fine Print

✓ The authors report a case of an iatrogenic carotid—cavernous fistula (CCF) associated with intracranial angioplasty. Angioplasty was performed using a 3 × 10-mm Open Sail coronary balloon in a patient with high-grade stenosis of the left cavernous internal carotid artery (ICA). After angioplasty, a perforation developed in the cavernous ICA, resulting in a CCF. A 3.5 × 9—mm S670 coronary stent was used to treat the fistula. To the authors' knowledge, this is the first reported case in which a CCF developed after angioplasty was performed using a coronary balloon. Long-term angiographic and clinical evaluation is needed to test the suitability and durability of intracranial angioplasty and stent placement in the treatment of symptomatic intracranial stenosis.

Venous rupture during transvenous approach to a carotid-cavernous fistula

1989 ◽  
Vol 71 (1) ◽  
pp. 133-137 ◽  
Author(s):  
Wesley A. King ◽  
Grant B. Hieshima ◽  
Neil A. Martin
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
Balloon Occlusion ◽  
Alternative Methods ◽  
Ocular Motility ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
A Minor ◽  
Transvenous Approach

✓ An attempt at transfemoral transarterial balloon occlusion of a high-flow spontaneous carotid-cavernous fistula was unsuccessful because the carotid artery rent was too small for this approach. During a subsequent transvenous approach to the cavernous sinus through the jugular vein, the inferior petrosal sinus was perforated. A minor subarachnoid hemorrhage occurred before the tear could be sealed by the deposition of three Gianturco coils in the vein. The patient was taken to the operating room for emergency obliteration of the fistula and petrosal sinus in order to remove the risk of further hemorrhage. Under the guidance of intraoperative digital subtraction angiography, isobutyl-2-cyanoacrylate was injected directly into the surgically exposed cavernous sinus. Successful obliteration of the fistula was achieved with preservation of the carotid artery, and the angiography catheter was removed safely from the petrosal sinus. Although initially after surgery the patient had nearly complete ophthalmoplegia, at her 1-year follow-up examination she had normal ocular motility and visual acuity. The transvenous approach to the cavernous sinus and alternative methods of treatment of carotid-cavernous fistulas are discussed.

Spontaneous carotid—jugular fistula and carotid dissection in a patient with multiple intracranial arachnoid cysts and hemifacial atrophy: a generalized connective tissue disorder?

1995 ◽  
Vol 83 (3) ◽  
pp. 546-549 ◽  
Author(s):  
Wouter I. Schievink ◽  
David G. Piepgras ◽  
Douglas A. Nichols
Keyword(s):  
Carotid Artery ◽  
Connective Tissue ◽  
Internal Carotid ◽  
Jugular Vein ◽  
Connective Tissue Disorder ◽  
Carotid Artery Dissection ◽  
Arachnoid Cysts ◽  
Artery Dissection ◽  
Hemifacial Atrophy ◽  
Content Type

✓ The authors report a case of a 45-year-old woman with pulsatile tinnitus who was found to have an unusual spontaneous fistula between the petrous internal carotid artery and internal jugular vein. The fistula resolved spontaneously, possibly related to daily manual compression of the ipsilateral common carotid artery. The patient also had a contralateral carotid artery dissection, multiple intracranial arachnoid cysts, and hemifacial atrophy. Her medical history was significant for easy bruisibility, abnormal scarring, and mitral valve prolapse. This association appears unique and may represent a previously undescribed generalized connective tissue disorder.

Patient presentation, angiographic features, and treatment of strangulation-induced dissection of the internal carotid artery

2000 ◽  
Vol 92 (3) ◽  
pp. 481-487 ◽  
Author(s):  
Adel M. Malek ◽  
Randall T. Higashida ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Constantine C. Phatouros ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
Artery Dissection ◽  
Percutaneous Angioplasty ◽  
Consistent Finding ◽  
Content Type ◽  
Fine Print

✓ Domestic violence leading to strangulation by an abusive spouse can cause carotid artery dissection. This phenomenon is rare and has been described in only three previous instances. The authors present their management strategies in three additional cases.Three young women aged 24 to 43 years were victims of manual strangulation committed by their spouses 3 months to 1 year before presentation. Two of the patients suffered delayed cerebral infarctions before presentation and angiography demonstrated focal, mirror-image severe residual stenoses in the high-cervical internal carotid artery (ICA), which were characteristic of a healed chronic dissection; there was no evidence of fibromuscular dysplasia. One of these patients underwent unilateral percutaneous angioplasty with stent placement, and the other underwent bilateral percutaneous angioplasty. Both patients have recovered from their strokes and remain clinically stable at 8 and 20 months posttreatment, respectively. The third patient presented with bilateral ischemic frontal watershed infarctions resulting from an occluded left ICA and a severely narrowed right ICA. Given the extent of the established infarctions, this case was managed with a long-term regimen of anticoagulation medications, and the patient remains neurologically impaired.These cases illustrate the susceptibility of the manually compressed ICA to traumatic injury as a result of domestic violence. They identify bilateral symmetrical ICA dissection as a consistent finding and the real danger of delayed stroke as a consequence of strangulation. Endovascular therapy in which percutaneous angioplasty and/or stent placement are used can be useful in treating residual focal stenoses to improve cerebral perfusion and to lower the risk of embolic or ischemic stroke.

External carotid-cavernous fistula treated by arterial embolization

1974 ◽  
Vol 40 (1) ◽  
pp. 110-114 ◽  
Author(s):  
M. Stephen Mahalley ◽  
Stephan C. Boone
Keyword(s):  
Carotid Artery ◽  
Successful Treatment ◽  
Arterial Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Unusual Occurrence ◽  
Fine Print

✓ The unusual occurrence of a carotid-cavernous fistula supplied entirely by branches of the external carotid artery is presented, and its successful treatment by arterial embolization described.

CT demonstration of spontaneous internal carotid artery dissection

1985 ◽  
Vol 63 (5) ◽  
pp. 792-793 ◽  
Author(s):  
David J. Lubbers ◽  
Thomas A. Tomsick
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Ct Scanning ◽  
Carotid Artery Dissection ◽  
Radiographic Evaluation ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Intravenous Contrast ◽  
Content Type

✓ A case of internal carotid artery dissection is presented. It was diagnosed by computerized tomography (CT) and confirmed by angiography. The typical clinical presentation and radiographic evaluation are briefly reviewed. High-resolution CT scanning with intravenous contrast enhancement is a valuable diagnostic aid in the diagnosis of this entity.

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