title: Delayed caroticocavernous fistula after stent-assisted coil embolization of intracavernous carotid aneurysm: should we manage conservatively?
abstract: Constructive endovascular techniques remain the mainstay for the treatment of cavernous carotid aneurysms due to their efficacy. However, they do harbor risks of complications, such as thromboembolic events, arterial injuries, and vessel occlusions. A 58-year-old lady presented with delayed caroticocavernous fistula (CCF) 1 month after stent-assisted coil embolization of a cavernous carotid aneurysm (CCA). Following this, her caroticocavernous fistula resolved spontaneously with no further intervention. Our case demonstrates a unique presentation of a CCF as a delayed complication of stent-assisted coil embolization of CCA and the spontaneous resolution of the CCF. Symptomatic CCFs are commonly treated as an emergency in many institutions and the question arises as to whether we should adopt a conservative policy in the light of this case report.
authors.affiliation: Queens Hospital, Rom Valley Way, Romford, RM7 0AG, UK. chanhuanwee@yahoo.com
authors.forename: Huan Wee
authors.initials: HW
authors.lastname: Chan
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Haliasos
authors.forename: Shahram
authors.initials: S
authors.lastname: Derakhshani
authors.forename: Raghu
authors.initials: R
authors.lastname: Vindlacheruvu
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Chawda
mesh_terms: D015901:Angiography, Digital Subtraction; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000628:therapy*; D002343:Carotid Artery, Internal; D020216:Carotid-Cavernous Sinus Fistula / Q000175:diagnosis* / Q000628:therapy*; D002426:Cavernous Sinus; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed