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Journal of Korean Neurosurgical Society > Volume 34(5); 2003 > Article
Journal of Korean Neurosurgical Society 2003;34(5): 470-473.
Endovascular Treatment of a Traumatic Carotid-Jugular Fistula by Using Stent-Graft.
Jung Yong Ahn, Young Sun Chung, Sang Sup Chung, Byung Hee Lee
1Department of Neurosurgery, College of Medicine, Pochon CHA University, Seongnam, Korea. jyahn@cha.ac.kr
2Department of Radiology, Metro Hospital, Anyang, Korea.
ABSTRACT
Traumatic 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 right-sided pulsatile neck swelling and left-sided limb weakness 2 days following a stab wound. Neck computed tomography demonstrated a vascular mass protruding 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 were completely disappeared and the right internal carotid artery was preserved well. The stent-graft is a promising technology to obliterate the fistula and preserve the parent artery with relative safety.
Key Words: Arteriovenous fistula; Therapeutic embolization; Carotid artery injury
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