Indirect carotid–cavernous sinus fistula following mechanical thrombectomy: A case report of a rare iatrogenic injury with progressive presentation

Li, Sihao; Wang, Ting; Shen, Lin; Liu, Lunxin; Zhang, Changwei

doi:10.1016/j.amsu.2022.104130

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…Traumatic and iatrogenic fistulas tend to have high flow due to the associated often direct tear in the cavernous artery wall causing the fistula [1][2][3][4]. Iatrogenic occurrences have been reported after a variety of procedures including transsphenoidal pituitary surgery, balloon angioplasty, tumor embolization, carotid stenting, aneurysm coiling, and mechanical thrombectomy [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Due to the high-flow rate across the fistula, direct CCFs generally require treatment because they rarely heal spontaneously [4]. Furthermore, the high flow rate can result in various visual detriments when direct CCFs are left untreated due to possible raised intraocular pressure, compromised ocular motor nerve function, and orbital congestion which can detrimentally affect vision in the long run [3,11]. Consequently, if managing a CCF conservatively, careful monitoring of vision is suggested [1,4].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, if managing a CCF conservatively, careful monitoring of vision is suggested [1,4]. Endovascular treatment using different modalities offers a greater than 80% success rate, with complete recovery in most instances [2,3,11,15]. The successful endovascular treatment of direct CCFs depends on the specific flow conditions and the anatomy of the fistula.…”

Section: Introductionmentioning

confidence: 99%

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Delayed Iatrogenic Direct Carotid Cavernous Fistula Following Flow Diversion for Aneurysm With Spontaneous Healing: A Case Report

Voura,

Stulb,

Eller

et al. 2024

Cureus

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An abnormal connection between the carotid artery and cavernous sinus is referred to as a carotid cavernous fistula (CCF). A direct CCF results when the connection occurs between the intracranial internal carotid artery (ICA) and the cavernous sinus. These events are typically the result of a head injury, but can also be iatrogenic, resulting from various intracranial procedures. Direct CCF occurrences rarely heal spontaneously due to the high flow rate across the fistula. In this report, we present an uncommon case involving a delayed iatrogenic direct CCF, which developed following the placement of a pipeline flow-diverting stent that was used to treat a cerebral aneurysm. Interestingly, this unusual iatrogenic direct CCF subsequently spontaneously resolved within a few months. To our knowledge, this is the only case of a delayed CCF occurring with the use of a flow-diverting sent, which then resolved on its own. This report recounts our experience with the case.

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