Table 1. Literature review of iatrogenic direct CCF following mechanical thrombectomy.

ICA: internal carotid artery; MCA: middle cerebral artery; M1: MCA segment 1; CN VI: cranial nerve six; CCF: carotid-cavernous fistula; NA: not available

Literature review of iatrogenic direct CCF following mechanical thrombectomy
Author	Alan et al. [3]			Akpinar et al. [2]	Matsumoto et al. [12]	Current study
	Case 1	Case 2	Case 3
Site of occlusion	Tandem right ICA terminus and MCA	Left ICA terminus to left M1	Right ICA (petrous, lacerum, proximal cavernous segment), proximal right M1	Right distal ICA and right MCA	Right M1	Left MCA
Number of passes	1	2	1	NA	1	2
Procedure	Stent retriever thrombectomy with local aspiration; stenting of cervical carotid	Stent retriever thrombectomy with local aspiration	Stenting of the cervical/cavernous/lacerum carotid; manual aspiration thrombectomy	Stent retriever thrombectomy with local aspiration	Stent retriever thrombectomy	Stent retriever thrombectomy with local aspiration
Initial CCF symptoms	Asymptomatic	Asymptomatic	Right CN VI palsy, proptosis, chemosis (asymptomatic after 2 weeks)	NA	Chemosis, hyperemia	Asymptomatic
Management of CCF	Conservative	Conservative	Embolization via transvenous inferior ophthalmic vein approach (after initial conservative management)	Conservative (ICA was not recanalized)	Embolization via transvenous inferior petrosal sinus approach (three weeks post- thrombectomy)	Embolization via transarterial approach to superior ophthalmic vein; 10 days later, pipeline embolization of residual pseudoaneurysm
Follow-up	1.5 years: asymptomatic	4 months: asymptomatic	2.5 years: asymptomatic	Died 2 days postoperatively	3 months: asymptomatic	6 months: asymptomatic