Magnesium alloy covered stent for the treatment of a direct carotid-cavernous fistula in the rabbit common carotid artery

Objective To introduce the carotid-cavernous fistula (CCF) model, and evaluate the feasibility of a magnesium alloy covered stent (MACS) to treat a CCF model in the rabbit common carotid artery (CCA). Methods In 12 New Zealand rabbits, a CCF model was created with the right CCA and external jugular vein (EJV) using side-to-side anastomosis. A MACS was inserted into the CCF model under fluoroscopic guidance. CCF occlusion was studied through follow-up angiograms at 3, 6, and 12 months after stent placement. Results CCF models with pulsatile exophthalmos, conjunctival congestion, and extroversion of the eyes were successfully established in all 12 rabbits before stent placement. Stent placement was technically successful in all rabbits except two, giving a technique success rate of 83% (10/12). Complete CCF occlusion was achieved without endoleak in 10 rabbits by angiography immediate, and at 3rd, 6th and 12th month after operation. Conclusion The creation of the CCF model with the correct CCA and EJV by side-to-side anastomosis was successful and reproducible, and MACS was proved to be one of the feasible approaches for occlusion of a CCF. Key words: Carotid-cavernous fistula; Magnesium alloy; Covered stent; Rabbit