An Hybrid 2-Stage Technique to Treat a Post-Traumatic Internal Carotid-Jugular Fistula

Correção cirúrgica de fístula carotídeo-jugular traumática

“…9 Additionally, arterial reconstruction with autologous vein grafts is a more durable solution with a lower risk of infection than prosthetic materials. 3,4 However, venous grafts may undergo late dilation, especially in younger patients, as in the case presented here, demanding careful follow-up. 2,3 The great saphenous vein can be used, with low rates of thrombosis and infection, but this requires an additional incision in the lower limb, with consequent increase in the duration of surgery.…”

“…1,2 A penetrating trauma can lead to formation of pseudoaneurysms (PSA) and, if there are also venous injuries, to formation of an AVF. 2,3 If left untreated, depending on their site and size, these vascular injuries can cause complications such as congestive heart failure, cerebral ischemia, thromboembolism, or bleeding. 3,4 The first observations of AVFs were made by Hunter in 1757 and published in 1764.…”

“…2,3 If left untreated, depending on their site and size, these vascular injuries can cause complications such as congestive heart failure, cerebral ischemia, thromboembolism, or bleeding. 3,4 The first observations of AVFs were made by Hunter in 1757 and published in 1764. 5 The first description of a post-traumatic carotid-jugular fistula was published by Warren et al in 1951.…”

“…Surgery is less difficult during the initial stages, because fibrosis and collateral circulation distort the anatomy and increase the risk of dissection. 3,7 Early intervention can also prevent hemorrhages and formation of PSA. These injuries can be treated using conventional surgical techniques or endovascular methods.…”

Traumatic extracranial internal carotid-jugular fistula leading to serious injury: a case report in forensic assessment

“…Acquired fistula could only have arisen in one of the two ways, i.e. from a simultaneous small injury that affected the artery and the adjacent jugular vein but was not detected at the initial examination, alternatively, raised from the hematoma and possible infection or inflammation associated with the hematoma [14,15]. Arteriovenous fistula involves abnormal traffic of blood between the artery and vein resulting in vascular murmur and tremor.…”