Embolización con coils de fístula carótido-yugular espontánea. Reporte de caso y revisión de la literatura

Abstract

Carotid-jugular fistulas are infrequent but very symptomatic vascular lesions whose opportune treatment avoids the appearance of regional and systemic complications. The first line of management is occlusion through endovascular techniques, being detachable balloon the most commonly used technique. Recently, an alternative treatment through balloon-assisted coils embolization was described with promising results. We present the case of a teenage patient with one year of evolution of pulsatile mass of increasing volume in the left submandibular region, associated with thrill, murmur and hoarse voice. A digital substraction angiography was performed showing presence of a high-flow, large size arteriovenous fistula between the external carotid artery and the internal jugular vein. Balloon-assisted coils embolization was carried out with successful occlusion of the fistula and resolution of the presented symptoms, without associated adverse events.