Endovascular Treatment of a Traumatic Carotid Cavernous Fistula Concomitant with Intracranial Pseudoaneurysm by Flow Diverter, 2-Dimensional Operative Video.

Abstract

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). 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.