Endovascular Embolization of a Superficial Temporal Artery Arteriovenous Fistula and Aneurysm

The superficial temporal artery (STA), a terminal branch of the external carotid artery, is prone to vascular injury due to its location. We report a case of a 90-year-old male with multiple comorbidities who was incidentally diagnosed with an STA arteriovenous fistula (AVF) and a distal STA aneurysm. Complete endovascular obliteration of both lesions was achieved using Onyx embolization. This case highlights the rare presentation of concurrent STA fistula and aneurysm, emphasizing the efficacy and safety of endovascular embolization as a minimally invasive therapeutic approach, particularly in high-risk surgical candidates.