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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
Guidewire-induced carotid cavernous fistula
T S Kim1, M Ezura, A Takahashi
1Department of Neurosurgery, Kohnan Hospital; Sendai, Japan.
Summary
A rare carotid cavernous fistula complication during aneurysm embolization spontaneously resolved. This case highlights a potential risk during endovascular procedures for internal carotid artery aneurysms.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Radiology
Background:
- Carotid cavernous fistulas (CCFs) are abnormal communications between the carotid artery system and the cavernous sinus.
- Endovascular embolization is a common treatment for intracranial aneurysms, but carries potential risks.
Purpose of the Study:
- To report a rare case of CCF occurring during endovascular embolization of a carotid cave aneurysm.
- To discuss the potential cause and management of this complication.
Main Methods:
- A 48-year-old female underwent endovascular embolization for a left carotid cave aneurysm.
- The aneurysm was occluded using Guglielmi detachable coils and a neck plasty technique.
- A complication of CCF was noted during the procedure.
Main Results:
- The left carotid cave aneurysm was successfully occluded.
- A carotid cavernous fistula developed, presumed due to guidewire manipulation in the intracavernous internal carotid artery.
- The CCF was asymptomatic and managed conservatively with follow-up.
Conclusions:
- Spontaneous resolution of the CCF occurred within two weeks, as confirmed by follow-up angiography.
- This case underscores the importance of vigilance for rare complications during complex endovascular interventions.