Introduction A Direct Carotid Cavernous Fistula is an abnormal shunt between the internal carotid artery and the cavernous sinus. Covered stents are usually not used for neurointerventional procedures due to concerns of occlusion of perforating vessels and being thrombogenic. We present a case demonstrating safety and efficacy of a covered stunt in a direct Carotid Cavernous Fistula.

Case Description A 57yrs old man was involved in an accident, sustained a direct left eye injury. He developed a Carotid cavernous fistula one day after the accident which was confirmed on computed tomography angiography. We performed endovascular treatment by implanting a covered stent (Papyrus 4x15mm) in the cavernous segment of internal carotid artery covering the fistulous point with use of 6F guided catheter and no intermediate catheter. During the procedure, half a vial of IV Aspirin and IV Tirofiban were administered according to the protocol.

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Abstract P047 Figure 1

a: Left Superior Ophthalmic Vein (marked with blue arrow). Fig 1b: Pre:Treatment Cavernous Carotid Fistula - Dilated Superior Ophthalmic Vein (marked with red arrow). Site of Fistula (marked with yellow circle). Fig 1c: Post Stent Placement Complete Resolution of Fistula

Results Covered Stents demonstrate good navigability, as evidenced in this case with direct positioning, eliminating the need for an intermediate catheter. Also, Acute loading of anti-platelets works with covered stents - no thromboembolic events nor the bleeding was seen in this case.

Disclosure of Interest no.