Discover the case of a 55-year-old male presenting with weeks of diplopia and sudden left ptosis, following a bicycle accident. Examination revealed left ptosis with scleral injection, left medial rectus palsy, and right abducens palsy. Imaging unveiled bilateral indirect cavernous-carotid fistula (CCF). The medical team chose an innovative hybrid neurosurgical and endovascular approach to embolize the cavernous-carotid fistula: watch the procedure now!