Incidental direct carotid-cavernous fistula in a patient with high-grade internal carotid artery stenosis

The concurrent occurrence of internal carotid artery [ICA] stenosis and carotid-cavernous fistula [CCF] is infrequent. We report the case of a 59-year-old man with symptomatic high-grade stenosis of left ICA who was referred to our hospital for surgical treatment. An ipsilateral direct CCF was found incidentally during operation. Ultimately, the two lesions were successfully treated with a covered stent while the ICA was preserved. The result of our study may provide further insight into this rare combination of diseases