Use of a Balloon Catheter for Occlusion of Iatrogenic Direct Carotid-Cavernous Fistula Occurring during a Neurointerventional Procedure

Neurointerventional procedures involving the anterior circulation, including aneurysm coiling, mechanical thrombectomy (MT), and intracranial angioplasty, can result in rare life-threatening complications such as iatrogenic carotid-cavernous fistulas (CCFs). Here, we describe the successful use of a balloon catheter for the occlusion of an iatrogenic CCF during neurointerventional procedures in a 78-year-old woman. The patient underwent successful MT for right middle cerebral artery occlusion; however, her symptoms worsened the day after the procedure; therefore, intracranial stenting was planned. An iatrogenic CCF that occurred during the neurointerventional procedure was successfully occluded using a balloon catheter. Neurointerventionalists should be aware of iatrogenic CCFs and be prepared to treat this rare complication. The double-lumen balloon catheter may be a useful tool for the transarterial treatment of iatrogenic CCFs.