Intracranial arteriovenous fistula caused by endovascular stent-grafting and dilatation.
A 58-year-old man developed a self-occluding arteriovenous fistula following stent-grafting of the right internal carotid artery (ICA). Due to prolonged ischaemic neurological deficits carotid angiography had been performed 3 weeks previously. It revealed marked atherosclerotic lesions predominantly narrowing the distal right carotid siphon. MRI confirmed ischaemic lesions and massive deficits of perfusion in the right ICA cerebral territory. Stent-grafting was performed successfully, but subsequent angiography revealed a new arteriovenous fistula adjacent to the stent, between the right carotid siphon and the cavernous sinus. On angiography 10 days later, the fistula no longer was present, and flow MRI were normal; the patient was by then asymptomatic. Arteriovenous fistula can thus complicate following endovascular stenting.
Department of Nuclear Medicine, Universitätsklinik Saarland, 66421 Homburg, Germany. ramomo@uniklinik-saarland.de
M O
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Möllers
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Reith
D001164:Arteriovenous Fistula / Q000209:etiology* / Q000473:pathology; D002545:Brain Ischemia / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000209:etiology* / Q000601:surgery*; D002426:Cavernous Sinus / Q000002:abnormalities*; D002533:Cerebral Angiography; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015607:Stents; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods*