Images in a 40-year-old man with a TCCF and a TCA of the left supraclinoid ICA.
A, Left lateral carotid angiogram reveals a TCCF with complete steal phenomenon and no opacification of the supraclinoid ICA or TCA.
B, The TCCF was occluded by a detached balloon. A small TCA at the supraclinoid ICA (arrow) was demonstrated and subtotally obliterated with GDCs.
C, The patient had a recurrent TCCF due to puncture of the detached balloon; this was eventually occluded by using a detachable balloon, GDCs, and liquid adhesive, with preservation of the ICA.