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Case report
Direct puncture of the highest cervical segment of the internal carotid artery for treatment of an iatrogenic carotid cavernous fistula in a patient with Ehlers-Danlos syndrome
  1. Adam Khan1,
  2. Neeraj Chaudhary2,
  3. Aditya S Pandey3,
  4. Joseph J Gemmete2
  1. 1Department of Medical School, University of Michigan, Ann Arbor, Michigan, USA
  2. 2Department of Radiology, Division of Interventional Neuroradiology, University of Michigan, Ann Arbor, Michigan, USA
  3. 3Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Joseph J Gemmete, Department of Radiology, Division of Interventional Neuroradiology, University of Michigan, 1500 E Medical Center Dr, UH B1 D328, Ann Arbor, MI 48109-5030, USA; gemmete{at}med.umich.edu

Abstract

A case of an iatrogenic direct carotid cavernous fistula in a patient with a history of Ehlers-Danlos syndrome and multiple aneurysms is reported. The fistula developed after unsuccessful surgical thrombectomy and revision of an occluded interposition graft inserted to treat a right internal carotid artery aneurysm. Direct puncture of the right internal carotid artery at the level of the skull base was performed to close the fistula. This case shows that direct puncture at the highest cervical segment of the internal carotid artery is another option for treatment of a direct carotid cavernous fistula when a standard transarterial or transvenous approach is not feasible.

  • Aneurysm
  • angiography
  • arteriovenous malformation
  • CT angiography
  • vascular malformation

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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