CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(04): 638-641
DOI: 10.1055/s-0042-1757629
Case Report

Direct Carotid-Cavernous Fistula Caused by Internal Carotid Artery Perforation by a Microcatheter Body during Mechanical Thrombectomy

Satoshi Miyamoto
1   Department of Neurosurgery, Mito Medical Center, Mito, Ibaraki, Japan
2   Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
3   Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
Noriyuki Kato
1   Department of Neurosurgery, Mito Medical Center, Mito, Ibaraki, Japan
,
Tomosato Yamazaki
1   Department of Neurosurgery, Mito Medical Center, Mito, Ibaraki, Japan
,
Akinari Yamano
1   Department of Neurosurgery, Mito Medical Center, Mito, Ibaraki, Japan
,
Yoshimitsu Akutsu
1   Department of Neurosurgery, Mito Medical Center, Mito, Ibaraki, Japan
,
Susumu Yasuda
1   Department of Neurosurgery, Mito Medical Center, Mito, Ibaraki, Japan
,
Yuji Matsumaru
2   Division of Stroke Prevention and Treatment, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
3   Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
Eiichi Ishikawa
3   Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
› Author Affiliations

Abstract

Rapid advances in emergent mechanical thrombectomy have resulted in a higher occurrence of arterial perforations during neurointerventions. Here, we report a case of internal carotid artery (ICA) perforation during mechanical thrombectomy in a 78-year-old man with a left middle cerebral artery occlusion. The ICA was perforated by a microcatheter during thrombectomy, forming a direct carotid-cavernous fistula. A two-stage drainer occlusion was conducted because of cortical venous reflex aggravation and ocular symptoms. Here, we report the perforation details and treatment, adding to evidence that ICA perforation with the microcatheter body is a concern during mechanical thrombectomy.

Informed Consent

The authors certify that they have obtained all appropriate patient consent.




Publication History

Article published online:
19 October 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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