title: Endovascular Treatment of Complex Carotid-Jugular Fistula.
abstract: Inadvertent complications of jugular vein catheterization are not uncommon, however, a persistent symptomatic carotid-jugular fistula has been rarely reported. A 72-year-old male with infected surgical wound after coxofemoral disarticulation for sarcoma presented with symptoms of acute right heart failure. A fistula between the right common carotid artery (CCA) and the internal jugular vein was demonstrated on Doppler ultrasound and confirmed on computed tomography angiogram. Catheterization of the right CCA seemed not possible using a conventional femoral approach due to the tortuosity and elongation of the brachiocephalic artery. A small incision in the right temporal area was used to access the superficial temporal artery and a wire was advanced retrograde into the aorta where it was snared from below, allowing for successful treatment of the fistula with a covered stent. This alternative technique may facilitate safe and stable carotid artery stenting even in patients with a severely tortuous access route due to atherosclerotic disease.
authors.affiliation: 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Alonso-Argüeso
authors.affiliation: 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rodriguez-Morata
authors.affiliation: 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Vera-Arroyo
authors.affiliation: 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain.
authors.forename: Maria Jesus
authors.initials: MJ
authors.lastname: Lara-Villoslada
authors.affiliation: 1 Department of Angiology and Vascular Surgery, Virgen de la Victoria University Hospital, Málaga, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Gomez-Medialdea
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001027:Aortography / Q000379:methods; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008297:Male; D011677:Punctures; D015641:Radiography, Interventional; D015607:Stents; D013699:Temporal Arteries / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
keywords: carotid; endovascular; fistula; jugular; stent