Traumatic carotid-cavernous fistula: endovascular treatment with onyx and coils.

SUMMARY: Carotid cavernous fistulas (CCF) are mostly post-traumatic and are due to a tear of the internal carotid artery (ICA) inside the cavernous sinus. The improvement of endovascular techniques with venous approach enables the preservation of internal carotid artery patency in most cases when detachable balloons fail in order to reconstruct and repair the tear in the ICA. The case described here has a giant aneurysmatic dilatation of the cavernous sinus and inferior petrosal sinus. We associate coils and Onyx to occlude the lesion preserving and repairing the large hole of the fistula.

Internal carotid artery pseudoaneurysm after tonsillectomy treated by endovascular approach. A case report.

SUMMARY: Surgery on the head and neck region may be complicated by vascular trauma, caused by direct injury on the vascular wall. Lesions of the arteries are more dangerous than the venous one. The traumatic lesion may cause laceration of the artery wall, spasm, dissection, arteriovenous fistula, occlusion or pseudoaneurysm. We present a case of a child with a giant ICA pseudoaneurysm after tonsillectomy, manifested by pulsing mass and respiratory distress, which was treated by endovascular approach, occluding the lesion and the proximal artery with Histoacryl. We reinforce that the endovascular approach is the better way to treat most of the traumatic vascular lesions.