CAROTID-JUGULAR FISTULA AFTER GREENFIELD FILTER INSERTION

A carotid-jugular fistula complicated the placement of a Greenfield fi lter via the right internal jugular percutaneous passage: the local si gns of an arterio-venous fistula were associated with right parietal i nfarctus neurological symptoms. A crossography showed a carotid-jugula r fistula and it limited dissection of the original carotid artery. An elective echoguided compression failed. The surgical treatment elimin ated the fistula, fixed the carotid dissection and placed a vena cava. filter with an excellent result 34 months later. Percutaneous placeme nt of vena cava filters can lead to rare vascular complications such a s carotid-jugular fistulas which can, in certain cases, be treated wit h an elective external compression or endovascular procedures. Surgery offers a reliable technical solution that is complete and stable in t ime, particularly with recent fistulas and associated neurological sym ptoms (J Mal Vase 1996; 21: pages 308-311).