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Delayed Rupture Presenting as Direct Carotid-Cavernous Fistula after Flow Diversion for a Cavernous Internal Carotid Artery Aneurysm with Enlarging Blebs: A Case Report

A dispatch from PubMed — filed

This study aimed to report a case of delayed rupture presenting as a direct carotid-cavernous fistula following flow diversion for a cavernous internal carotid artery aneurysm with enlarging blebs. CASE PRESENTATION: An 82-year-old woman with a progressively enlarging right cavernous internal carotid artery aneurysm and 2 enlarging blebs underwent flow diversion using a Pipeline embolization device (Medtronic,...

Clinical Takeaway

No actionable change for audiologists; this neurovascular case report is relevant to neurosurgeons and interventional neuroradiologists, with only peripheral relevance to ENT or audiology practice.

Why It Matters

Rare delayed complications of endovascular aneurysm treatment highlight the need for prolonged post-procedure imaging surveillance, which is relevant for multidisciplinary teams including skull-base specialists who may co-manage such patients.

Key Points
  1. 01Single case report of delayed carotid-cavernous fistula after flow diversion for a cavernous ICA aneurysm.
  2. 02Complication appeared as a direct fistula (abnormal artery-vein connection) following initial treatment.
  3. 03Enlarging blebs (blister-like outgrowths) on the aneurysm were noted prior to rupture.
  4. 04Peripheral relevance to audiology only via skull-base tumor/vascular co-management.
  5. 05Case reports represent the lowest level of clinical evidence.
Claims & Evidence

Flow diversion for cavernous ICA aneurysms with enlarging blebs can result in delayed rupture presenting as a direct carotid-cavernous fistula.

studypartially supported
Research metadata
PMID
42299238
DOI
10.5797/jnet.cr.2026-0025.
Journal
Journal of Neuroendovascular Therapy
Publication type
case_report
Evidence level
4
Sample size
1
Population
Single patient with cavernous internal carotid artery aneurysm with enlarging blebs treated with flow diversion
Intervention
Flow diversion device placement for cavernous ICA aneurysm

Primary outcomes

Occurrence and characterization of delayed carotid-cavernous fistula following flow diversion

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