2019 AMI Online Salon

Repair of Internal Carotid Artery – Internal Jugular Vein Fistula

Project Details

  • Entrant Name: Jill Gregory
  • Membership Type: Professional Submission
  • Address: New York, NY
  • Client: Dr. Rui Feng
  • Medium/software used: Adobe Illustrator and Photoshop
  • Final presentation format: Surgical Journal
  • Primary Audience: Surgeons

Project Description

This illustration accompanies a case report of a patient who had recovered from a gunshot to the neck 10 years prior. He had subsequently developed a large aneurysm between his internal carotid artery and internal jugular vein. In this figure, panel A describes the pre-op anatomy: 1. a large aneurysm with mixing of oxygenated and deoxygenated blood; 2. retrograde blood flow in the distal IJV via the proximal ICA; 3. no antegrade blood flow in the distal ICA, instead retrograde flow via a tortuous external carotid artery (ECA) and dilated ophthalmic collaterals; and 4. two aneurysms in the anterior cerebral artery. Panel B shows the repair, with correct blood flow established through the placement of two stents in both the IJV and the ICA, and 19 coils deployed to fully occlude the aneurysm. Due to the extremely complicated vascular anatomy, only a simple render of the skull was included for context.