Stabilization of Spontaneous Cerebral Coil Detachment with Stent during Endovascular Treatment of Direct Carotido-Cavernous Fistula: A Case Report

Abstract

Carotido-cavernous fistula (CCF) is a rare vascular anomaly and endovascular treatment plays a crucial role in managing of it. However, complications can arise, including spontaneous coil detachment, which can lead to embolic or thrombotic events. In this case report, we present the case of a 56-year-old man who suffered multiple skull base and facial bone fractures, along with a traumatic subarachnoid hemorrhage, resulting from a fall. The patient was diagnosed with a right-sided traumatic carotid-cavernous fistula, and endovascular treatment with coiling was performed. During the procedure, a coil spontaneously detached, to address this complication, a stent was deployed to fix the dislodged coil to the carotid artery wall, ensuring proper occlusion and minimizing the risk of further embolic or thrombotic events. This rescue technique provides stability to the detached coil, minimizing the risk of migration or embolization, and preserves the integrity of the internal carotid artery. Spontaneous coil detachment is a challenging situation during endovascular treatment, but with proper techniques, such complications can be managed effectively, ensuring successful closure of the carotido-cavernous fistula and patient safety.