Pseudoaneurysm formation following transarterial embolization of traumatic carotid-cavernous fistula with detachable balloon: An institutional cohort long-term study

Figure 5 A 40-year-old male presented with left proptosis and audible bruit after a motor vehicle accident 4 months prior. A and B: Anteroposterior (AP) and lateral views of the left internal carotid artery (LICA) injection showed large traumatic carotid-cavernous fistula without antegrade flow into the anterior and middle cerebral arteries; C and D: AP and lateral views of the LICA demonstrated a detachable balloon during inflation at the left posterior cavernous sinus under road-mapping; E and F: AP and lateral views of the LICA injection revealed complete obliteration of the fistula; G: Lateral view of three-dimensional reconstructed images of the LICA using computed tomography angiography (CTA) of the LICA obtained 3 d after embolization showed recurrent traumatic carotid-cavernous fistula with displacement of a balloon into the anterior cavernous sinus; H: Lateral view of the LICA injection revealed complete obliteration of the fistula after retreatment with another balloon; I: Three-dimensional reconstructed image of both ICAs, vertebrobasilar system, and skull base using CTA obtained 6 months after embolization confirmed no residual pseudoaneurysm (grade 0).