Treatment of a recurrent traumatic carotid-cavernous fistula: vertebro-basilar approach after surgical occlusion of the internal carotid artery.

A case of a post-traumatic carotid-cavernous fistula treated by endovascular approach through the vertebrobasilar system is reported. The 16 year old female patient was hurt in a car accident. The instantly-occurring carotid-cavernous fistula was treated with a Fogarty catheter, the internal carotid artery being occluded during this procedure. Ten years later the fistula recurred with a predominantly cortical venous drainage. The fistula was closed with two detachable balloons by an endovascular approach from the vertebrobasilar system via the posterior communicating artery. The small residual fistula, fed by the external artery was occluded by a venous approach via the internal jugular.