Carotid-jugular fistulas are infrequent but highly symptomatic vascular lesions whose timely treatment avoids the appearance of local and systemic complications. The first line of management is occlusion through endovascular techniques, with the detachable balloon being the most commonly used technique. Recently, alternative treatment was described through embolization with coils by a balloon-assisted technique, with promising results. We present the case of an adolescent patient with one year of history of pulsating mass of increasing volume in the left submandibular region, associated with thrill and hoarse voice. Digital subtraction angiography was performed, documenting the presence of a large, high-flow arteriovenous fistula between the external carotid artery and the internal jugular vein. The patient received coil embolization using the balloon-assisted technique, with successful occlusion of the fistulae and resolution of the symptoms presented,with no complications.
Rev. Chil. Neurocirugía 45: 255-258, 2019