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KMID : 1005420220240030291
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Journal of Cerebrovascular and Endovascular Neurosurgery
2022 Volume.24 No. 3 p.291 ~ p.296
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Deconstructive repair of a traumatic vertebrovertebral arteriovenous fistula via a contralateral endovascular approach
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Sathiji K. Nageshwaran
Francis Deng
Robert W. Regenhardt
Alvin S. Das
Naif M. Alotaibi
Aman B. Patel
Christopher J. Stapleton
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Abstract
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Vertebrovertebral arteriovenous fistulas (VVAVFs) are rare entities that lack consensus guidelines for their management. Our case describes the successful treatment of a traumatic VVAVF via a contralateral deconstructive endovascular approach. A 64-year-old female presented following a traumatic fall. Computed tomography angiogram highlighted a 2 cm pseudoaneurysm of the right vertebral artery (VA) with epidural contrast enhancement and a hematoma with flow voids within the epidural space. Digital subtraction angiography showed a VVAVF at C2-3 with retrograde filling of the distal right VA. Having undergone several unsuccessful passes of the proximal dissection flap in the right VA, the patient underwent a contralateral deconstructive approach with correction of the VVAVF without complication. The remaining feeding branches had occluded after 1 week. The patient made a complete recovery without neurological sequelae at 3-month follow-up.
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KEYWORD
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Endovascular, Arteriovenous fistula, Vertebral artery, Fistula, Endovascular procedures
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