Endovascular treatment of external carotid-jugular fistulae in the parotid region.

A series of eight patients with large arteriovenous fistulae involving the external carotid artery and the jugular vein that were treated with the endovascular technique are reviewed. The origin of the fistula was congenital in six patients, spontaneous in one, and iatrogenic in one. All the fistulae were located in the parotid region, and single channel arteriovenous shunts were evident in all the cases. Endovascular treatment was performed with a detachable balloon. All the patients were cured, and no complications were observed. No recurrences were observed after a clinical follow-up of 6 months to 12 years (mean, 5 yr). Endovascular treatment offers the advantage of being less traumatic because it avoids facial scars and injury to the facial nerve. This is especially important in children, who most commonly have this condition. In our group, endovascular treatment is considered first in the management of external carotid-jugular fistulae.