J Neurosonol Neuroimag.  2022 Jun;14(1):63-66. 10.31728/jnn.2022.00120.

Use of a Balloon Catheter for Occlusion of Iatrogenic Direct Carotid-Cavernous Fistula Occurring during a Neurointerventional Procedure

• Kang CH
• Kim HJ
• Choi JC
• Kim JG

• KMID: 2534562
• DOI: http://doi.org/10.31728/jnn.2022.00120

Abstract

Neurointerventional procedures involving the anterior circulation, including aneurysm coiling, mechanical thrombectomy (MT), and intracranial angioplasty, can result in rare life-threatening complications such as iatrogenic carotid-cavernous fistulas (CCFs). Here, we describe the successful use of a balloon catheter for the occlusion of an iatrogenic CCF during neurointerventional procedures in a 78-year-old woman. The patient underwent successful MT for right middle cerebral artery occlusion; however, her symptoms worsened the day after the procedure; therefore, intracranial stenting was planned. An iatrogenic CCF that occurred during the neurointerventional procedure was successfully occluded using a balloon catheter. Neurointerventionalists should be aware of iatrogenic CCFs and be prepared to treat this rare complication. The double-lumen balloon catheter may be a useful tool for the transarterial treatment of iatrogenic CCFs.

Keyword

carotid-cavernous sinus fistula; endovascular procedures; balloon occlusion