Treatment of Traumatic Direct Carotid Cavernous Fistula With a PK Papyrus Covered Stent: A Report of 2 Cases

Background: Traumatic direct carotid cavernous fistulas results in a direct communication between the internal carotid artery and the cavernous sinus. Covered stents are not frequently used in neuro-endovascular procedures due to concerns primarily about occlusion of perforating vessels. There are however several factors in direct carotid cavernous fistulas that make it more amenable to covered stenting than other diseases treated endovascularly. Methods: Wepresent 2 cases of occlusion of traumatic direct carotid cavernous fistulas utilizing the PK Papyrus stent. Results: In our first case, this device was successfully used as a salvage technique afterfailure of conventional techniques and in the second case it was used as primary treatment. Conclusion: The properties of the PK Papyrus covered stent are promising in overcoming the difficulties of other covered stents and warrants further investigation.