J Korean Neurosurg Soc.  2003 Nov;34(5):470-473.

Endovascular Treatment of a Traumatic Carotid-Jugular Fistula by Using Stent-Graft

• Ahn JY
• Chung YS
• Chung SS
• Lee BH

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.

Keyword

Arteriovenous fistula; Therapeutic embolization; Carotid artery injury

MeSH Terms

Adult
Aneurysm, False
Angiography
Arteries
Arteriovenous Fistula
Carotid Arteries
Carotid Artery Injuries
Carotid Artery, Internal
Embolization, Therapeutic
Extremities
Fistula*
Humans
Jugular Veins
Neck
Parents
Veins
Wounds, Stab