Traumatic Pseudoaneurysm of the External Carotid Artery with Arteriovenous Fistula Treated with Endosaccular Embolization

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Objective: A patient with very rare traumatic pseudoaneurysms of the external carotid artery with an arteriovenous fistula in whom rerupture could be prevented by endosaccular embolization is reported as the first of such cases.Case Presentation: A 32-year-old male underwent angiography for close examination of pulsating swelling in the left cheek 4 days after bilateral mandibular sagittal split ramus osteotomy and was found to have pseudoaneurysms in the left external carotid artery accompanied by an arteriovenous fistula. To preserve the parent vessel, emergency endosaccular embolization was performed. Complete occlusion of the pseudoaneurysms and arteriovenous fistula could be achieved, resulting in complete disappearance of the symptoms and an uneventful postoperative course.Conclusion: Endosaccular embolization is considered to be useful as a preventive measure against rerupture of pseudoaneurysms of the external carotid artery with arteriovenous fistula in which preservation of the parent artery is desirable if the lesions are distant from the skin or mucosal surface.