Vertebral Arteriovenous Fistula: A Rare Complication Following Transpedicular Occipitocervical Fixation in a Patient with Atlantoaxial Dislocation

AbstractVertebral arteriovenous fistula (AVF), a complication of a vertebral artery injury (VAI), is a rare but serious complication of upper cervical spine fixation surgery. We report a case of a 59-year-old female patient who had a vertebral AVF following transpedicular occipitocervical fixation surgery. Endovascular embolization of the AVF was successfully performed using ethylene vinyl alcohol. From this case we learned that preoperative evaluation of the course of the vertebral artery is necessary, and vertebral artery embolism is an effective and safe method to treat vertebral AVF after proof of a patent second vertebral artery.

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Traumatic arteriovenous fistula of the vertebral artery with spinal cord symptoms

Journal of Neurosurgery ◽

10.3171/jns.1977.46.5.0681 ◽

1977 ◽

Vol 46 (5) ◽

pp. 681-687 ◽

Cited By ~ 36

Author(s):

Chikao Nagashima ◽

Takashi Iwasaki ◽

Seiichi Kawanuma ◽

Arata Sakaguchi ◽

Akira Kamisasa ◽

...

Keyword(s):

Spinal Cord ◽

Vertebral Artery ◽

Arteriovenous Fistula ◽

Rapid Improvement ◽

Direct Closure ◽

Content Type ◽

Vertebral Arteriovenous Fistula ◽

Fine Print

✓ The authors report a case of a traumatic vertebral arteriovenous fistula with spinal cord symptoms. Direct closure of the fistula was followed by rapid improvement.

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Mild trauma causing cervical fracture through transverse foramen leading to a vertebral arteriovenous fistula

BMJ Case Reports ◽

10.1136/bcr-2021-241735 ◽

2021 ◽

Vol 14 (6) ◽

pp. e241735

Author(s):

Mikkel Schou Andersen ◽

Willy Krone ◽

Sune Munthe

Keyword(s):

Vertebral Artery ◽

Arteriovenous Fistula ◽

Vertebral Artery Dissection ◽

Artery Dissection ◽

Digital Subtraction ◽

Trauma Mechanism ◽

Transverse Foramen ◽

Cervical Fractures ◽

Vertebral Arteriovenous Fistula ◽

Ct Angiogram

Vertebral arteriovenous fistula (vAVF) is an uncommon vascular disease defined as abnormal connections between the vertebral artery or its branches extracranially with nearby venous structures. This case report outlines the case of a man in his late 70s presenting with C1–C3 fractures after a mild trauma falling down a small staircase. CT angiogram (CTA) gave suspicion of vertebral artery dissection and pseudoaneurysm; however, digital subtraction angiography revealed a fracture-induced vAVF successfully treated endovascularly with coils. In conclusion, cervical fractures involving the transverse foramen regardless of trauma mechanism should result in a CTA. Endovascular treatment with ipsilateral vertebral artery closure is preferred due to its feasibility and safety.

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A Successful Hybrid Repair for Vertebral Arteriovenous Fistula with Extracranial Vertebral Artery Aneurysm

Annals of Vascular Surgery ◽

10.1016/j.avsg.2014.07.038 ◽

2015 ◽

Vol 29 (1) ◽

pp. 126.e5-126.e8 ◽

Cited By ~ 1

Author(s):

Shinya Takahashi ◽

Keijiro Katayama ◽

Takaharu Tatsugawa ◽

Taijiro Sueda

Keyword(s):

Vertebral Artery ◽

Arteriovenous Fistula ◽

Artery Aneurysm ◽

Vertebral Arteriovenous Fistula ◽

Hybrid Repair ◽

Extracranial Vertebral Artery

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Excision of a congenital suboccipital vertebral arteriovenous fistula

Journal of Neurosurgery ◽

10.3171/jns.1972.37.4.0452 ◽

1972 ◽

Vol 37 (4) ◽

pp. 452-456 ◽

Cited By ~ 10

Author(s):

Albert D. Bartal ◽

Morris J. Levy

Keyword(s):

Arteriovenous Malformation ◽

Vertebral Artery ◽

Arteriovenous Fistula ◽

Surgical Approach ◽

Left Ventricular ◽

Content Type ◽

Vertebral Arteriovenous Fistula ◽

Cardiac Enlargement ◽

Major Consideration ◽

Fine Print

✓ This report describes the successful excision of a congenital vertebral arteriovenous malformation in an 8-year-old child. There was mild effort dyspnea and left ventricular cardiac enlargement; a left-to-right vertebral artery steal across the basilar trifurcation was a major consideration in planning the surgical approach.

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Acute Traumatic Vertebral Arteriovenous Fistula: Balloon Occlusion with the Use of a Contralateral Approach

Neurosurgery ◽

10.1227/00006123-198402000-00020 ◽

1984 ◽

Vol 14 (2) ◽

pp. 225-229 ◽

Cited By ~ 31

Author(s):

Richard E. Miller ◽

Grant B. Hieshima ◽

Steven L. Giannotta ◽

Verity S. Grinnell ◽

Mark C. Mehringer ◽

...

Keyword(s):

Vertebral Artery ◽

Arteriovenous Fistula ◽

False Aneurysm ◽

Distal Segment ◽

Balloon Occlusion ◽

Left Vertebral Artery ◽

Contralateral Approach ◽

Endovascular Occlusion ◽

Vertebral Arteriovenous Fistula

Abstract A traumatic fistula of the left vertebral artery to vertebral and epidural veins with an expanding suboccipital false aneurysm was trapped by endovascular occlusion with detachable balloons. The lesion was not amenable to treatment using the left vertebral artery alone for access. Distal trapping was accomplished by catheterizing the (contralateral) right vertebral artery and placing the balloon retrograde into the distal segment of the left vertebral artery. This maneuver extends the range of vertebral artery lesions for which detachable balloons, either alone or as an adjunct to operation, can be used.

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Recurrent Vertebral Arteriovenous Fistula after Surgical Repair: Treatment with a Self-Expanding Stent-Graft

Journal of Endovascular Therapy ◽

10.1177/152660280301000111 ◽

2003 ◽

Vol 10 (1) ◽

pp. 49-53 ◽

Cited By ~ 10

Author(s):

Ralf Surber ◽

Gerald S. Werner ◽

Tina U. Cohnert ◽

Thorsten Wahlers ◽

Hans R. Figulla

Keyword(s):

Vertebral Artery ◽

Arteriovenous Fistula ◽

Stent Graft ◽

Endovascular Repair ◽

Venous Catheter ◽

Vertebral Arteriovenous Fistula ◽

Initial Surgery ◽

Invasive Method ◽

Stent Graft Repair ◽

The Right

Purpose: To describe successful endovascular repair of a recurrent vertebral arteriovenous fistula (AVF) after surgical correction. Case Report: A 42-year-old woman presented with recurrent dizziness, nausea, and headaches. A loud bruit in the right neck was present. Central venous catheter insertion had been done 1 year previously, creating an angiographically documented right-sided vertebral AVF that was successfully excluded by a surgical procedure. Four weeks later, the AVF reappeared. Successful endovascular repair with a self-expanding stent-graft was performed. Follow-up over 12 months was uneventful, with a patent vertebral artery and no recurrence of symptoms. Conclusions: Endovascular stent-graft repair is feasible and offers a therapeutic alternative in the treatment of vertebral AVF, in particular for recurrence after initial surgery. This minimally invasive method may become the treatment of choice in the management of such lesions, preserving patency of the vertebral artery.

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Vertebral Arteriovenous Fistula: An Unwelcome Thrill

Case Reports in Emergency Medicine ◽

10.1155/2017/8386459 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Matthew K. Edwards ◽

Erica N. Christenson ◽

Brian M. Corliss ◽

Adam J. Polifka ◽

Brandon R. Allen

Keyword(s):

Emergency Department ◽

Vertebral Artery ◽

Arteriovenous Fistula ◽

Vascular Lesions ◽

Pulsatile Tinnitus ◽

Endovascular Techniques ◽

Av Fistula ◽

Vertebral Arteriovenous Fistula

Cervical vertebral AV fistulae are uncommon vascular lesions involving abnormal communication between the extradural vertebral artery and surrounding venous structures. We examine the case of a female evaluated in the emergency department with a vertebral AV fistula presenting classically as pulsatile tinnitus and later successfully treated with standard endovascular techniques. A discussion on the etiology, pathophysiology, and management of vertebral AV fistulae follows.

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Endovascular treatment of V3 segment vertebro-vertebral arteriovenous fistula with Willis covered stent: Case report and literature review

Interventional Neuroradiology ◽

10.1177/1591019918796607 ◽

2018 ◽

Vol 25 (1) ◽

pp. 97-101 ◽

Cited By ~ 2

Author(s):

Jiewen Geng ◽

Peng Hu ◽

Yongjie Ma ◽

Peng Zhang ◽

Hongqi Zhang

Keyword(s):

Case Report ◽

Literature Review ◽

Vertebral Artery ◽

Arteriovenous Fistula ◽

Covered Stent ◽

Digital Subtraction ◽

Pulsatile Tinnitus ◽

Vertebral Arteriovenous Fistula ◽

Before And After ◽

The Right

A 46-year-old male presented to our hospital suffering from right mastoid pulsatile tinnitus secondary to traffic trauma. Digital subtraction angiography was remarkable for a vertebro-vertebral arteriovenous fistula fed by the right vertebral artery at the C1 level. Dual platelet therapy was administrated before and after the operation, then a Willis covered stent was deployed at the orifice of the fistula. Post-operative angiography showed proper stent localization but some contrast agent leaking from the fistula. Angiography performed 6 months post-operatively demonstrated no leak from the fistula and the patency of the right vertebral artery. This case demonstrated that an intracranial covered stent could be used as an alternative, successful treatment for vertebro-vertebral arteriovenous fistula.

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