Vertebral Arteriovenous Fistula Research Articles

A Rare Case of Post-Traumatic Cervical Ligamentous Tear Complicated by Vertebral Arteriovenous Fistula (vAVF), with Successful Endovascular Treatment.

Post-traumatic vertebral arteriovenous fistula (vAVF) caused by motor vehicle accidents (MVA) is a rare condition in which there is abnormal communication between the vertebral artery and its adjacent veins. In a post-MVA setting, it is commonly associated with vertebral body fracture. In this paper, we report a case of a 19-year-old girl with a complete C2/C3 anterior and posterior ligament tear post MVA without any cervical bony injury. Initial plain computed tomography (CT) cervical scan showed a prevertebral hematoma. A CT angiogram (CTA) raised the suspicion of a pseudo-aneurysm at the right posterior C3 vertebral body. Further imaging with magnetic resonance imaging (MRI) demonstrated traumatic AVF at the C2/C3 level involving the V2/V3 right vertebral artery to the vertebral venous plexus. Digital Subtraction Angiography (DSA) further revealed a transected right vertebral artery at the C2/C3 level with an arteriovenous fistula and an enlarged vertebral venous plexus. The fistulous communication was successfully occluded with coils from a cranial and caudal approach to the transected segment right vertebral artery, with a total of eight coils. Post-MVA vertebral arteriovenous fistula (vAVF) is a rare sequela of vertebral bony injury at the cervical region, and is an even rarer association with an isolated ligamentous injury, whereby endovascular treatment with ipsilateral vertebral artery closure is a feasible treatment of vAVF.

Spontaneous Resolution of 2 High Flow Cervical Vertebral Arteriovenous Fistulas

Cervical vertebral arteriovenous fistula is a rare entity that is typically managed with endovascular techniques. We describe 2 consecutive cases of spontaneous obliteration of high flow cervical vertebral arteriovenous fistulas following angiography. Our cases pose an interesting natural history course, and we review the role of angiography in the unusual phenomenon of spontaneous obliteration of vascular malformations. These 2 cases bring forward the possibility of conservative management in such lesions.

Far lateral craniotomy for disconnection of vertebral dural arteriovenous fistula: how I do it.

Craniocervical junction (CCJ) vascular abnormalities can be challenging to treat because of the surrounding density of critical neurovascular anatomy. Although most dural arteriovenous fistulas (dAVFs) are now treated with endovascular surgery, dAVFs near the CCJ are often better suited for microsurgical obliteration with precise vascular control. We describe our microsurgical approach to treating dAVFs at the CCJ. This includes a far-lateral approach with a small incision centered over the transverse process of the atlas and circumferential skeletonization of the vertebral artery in addition to clipping the fistula to limit lesion recurrence. Definitive microsurgical treatment of CCJ dAVFs can be accomplished using a minimally invasive approach.

Vertebral arteriovenous fistula in neurofibromatosis type 1.

Vertebral arterio-venous fistulas (VAVFs) are uncommon lesions that can arise spontaneously or secondarily to iatrogenic or mechanical trauma. Among spontaneous cases, it is most commonly found to be associated with neurofibromatosis type 1 (NF1). We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities and outcome of VAVFs associated with NF1. A literature search was performed by using databases PubMed Central, Embase, Cochrane Library, and Ovid MEDLINE. Also, the grey area search was done using the "Google Scholar" search engine. On screening of the original full-text English language articles, a total of 48 cases were considered suitable for inclusion in this review. VAVFs in NF1 commonly present between 3rd and 6th decade of life affecting females 2.4 times more than males. Left-sided fistulae were more common than the right side and most seen in the upper V2 segment of the vertebral artery. Most VAVFs in NF 1 patients were treated with constructive (occlusion of fistula only) endovascular therapy (N.=26) with a high success rate. Moreover, pooled proportion of the outcome data have shown significant difference between the endovascular constructive and destructive procedure. The spontaneous VAVF, commonly associated with NF-1, often requires treatment. Awareness of the coexistence between NF1 and VAVF is crucial to avoid diagnostic delays and unnecessary surgical intervention leading to disastrous outcomes. Endovascular treatment is the preferred treatment approach while open surgical treatment is required in some complex fistulae and failure of endovascular techniques.

An Unusual Suspect for a Traumatic Arteriovenous Fistula in the Left Vertebral Artery

This case study discusses an unusual vertebral arteriovenous fistula of a patient with no history of an invasive medical procedure or underlying genetic disorders. The patient is a 54-year-old female with a history of tinnitus for 6 months behind the left ear prior to coming to the vascular laboratory. There was a connection between the left vertebral artery and the vertebral vein, which showed a mosaic pattern with a high velocity. The spectral Doppler waveform in the vertebral vein post the unintended anastomosis showed an arterialized venous Doppler waveform, confirming that the area of the interest was indeed an arteriovenous fistula. The image of the screening computed tomography performed on the same day did not show this connection or dilated venous system, possibly because of the small size of the fistula. A published literature suggests hyperextension as a possible suspect. There are a few test modalities that can identify an arteriovenous fistula, but ultrasound maybe the most desirable due to the fact that it does not involve an invasive procedure or a contrast dye. It is very important for a sonographer to learn the advanced information such as how to identify a true arteriovenous fistula with the analysis of Doppler waveform in the vein post the anastomosis. In doing so, it will increase the sonographer’s knowledge as well as promoting the field of ultrasound overall.

Complex Traumatic Vertebral Artery Arteriovenous Fistula with on Table Rupture – A Case Report

Complex Traumatic Vertebral Artery Arteriovenous Fistula with on Table Rupture – A Case Report

A Case of Spontaneous High-flow Vertebral Arteriovenous Fistula Treated by Trans-arterial Target Embolization Using Balloon Remodeling Technique

A Case of Spontaneous High-flow Vertebral Arteriovenous Fistula Treated by Trans-arterial Target Embolization Using Balloon Remodeling Technique

A Patient with Cervical Vertebral Arteriovenous Fistula Which Manifested as Radiculopathy: A Case Complicated by Neurofibromatosis Type 1

A Patient with Cervical Vertebral Arteriovenous Fistula Which Manifested as Radiculopathy: A Case Complicated by Neurofibromatosis Type 1

A case of vertebral arteriovenous fistula in a patient undergoing maintenance hemodialysis

BackgroundVertebral arteriovenous fistula (AVF) is an uncommon vascular disorder and defined as abnormal connections of the extracranial vertebral artery or its branches into the neighboring vein or deep venous plexus. This can be spontaneous or traumatic in origin. Spontaneous cases may be congenital or associated with dysplasia of vascular wall. Traumatic cases are due either to blunt or penetrating trauma, or iatrogenic trauma.Case presentationA vertebral AVF was detected by carotid duplex ultrasonography, and an endovascular treatment was successfully performed in a 72-year-old woman with 1 year history of hemodialysis.ConclusionAn extensive observation by carotid duplex ultrasonography is needed to detect vertebral AVF in patients who have a history of dialysis catheter insertion to internal jugular vein.

CME Test for Vertebral Artery Arteriovenous Fistula: Complication Following Cervical Spinal Fusion

CME Test for Vertebral Artery Arteriovenous Fistula: Complication Following Cervical Spinal Fusion

Endovascular Treatment of an Iatrogenic Vertebral Arteriovenous Fistula Presented with Weight Loss

目的：椎骨動静脈瘻（VAVF）はまれな病変であり，原因として外傷性または特発性が挙げられる．症状の多くは耳鳴りと血管雑音であるが，体重減少を主訴とした例はいまだない．症例：26歳，男性．体重減少と鎖骨上部の拍動性腫瘤を呈した．この入院の7年前，右頚静脈はGuillain-Barré症候群の治療のためにカテーテルを挿入されていた．脳血管撮影では，右椎骨動脈のV1 segmentと傍脊柱静脈叢との間に高流量VAVFが示された．瘻孔は，detachable coilを使用することにより，右椎骨動脈のinternal trappingにて治療した．術後経過は良好であり，追跡期間の31カ月間に再発はなかった．治療後体重は1年間で10 kg増加した．体重減少と本疾患の因果関係は明らかでないが，心不全患者の合併症の1つである体重減少と同様な機序が考えられる．結論：血管内治療はVAVFの治療として，第一選択となり得る．

Successful Endovascular Treatment with Covered Stent for Iatrogenic Vertebral Arteriovenous Fistula

Successful Endovascular Treatment with Covered Stent for Iatrogenic Vertebral Arteriovenous Fistula

A Case of Traumatic Vertebral Arteriovenous Fistula Treated by Coil Embolization Using Braided-stent for Preservation of Parental Artery

A Case of Traumatic Vertebral Arteriovenous Fistula Treated by Coil Embolization Using Braided-stent for Preservation of Parental Artery

High-resolution Cone-beam Computed Tomography Localization of an Iatrogenic Vertebral Arteriovenous Fistula for Trans-arterial Target Embolization

High-resolution Cone-beam Computed Tomography Localization of an Iatrogenic Vertebral Arteriovenous Fistula for Trans-arterial Target Embolization

Targeted Embolization of Vertebral Arteriovenous Fistula Associated with Type 1 Neurofibromatosis: Case Report

Targeted Embolization of Vertebral Arteriovenous Fistula Associated with Type 1 Neurofibromatosis: Case Report

Vertebral–venous fistula: an unusual cause for ocular symptoms mimicking a carotid cavernous fistula

Vertebral–venous fistulas (VVF), or vertebral–vertebral arteriovenous fistulas, are an uncommon clinical entity. Typically, they present as a result of a direct vascular connection between an extracranial branch of the vertebral...

Fístula arteriovenosa vertebral. Diagnóstico por auscultación

Cervical artery fistulas are rare arteriovenous malformations. The etiology of the vertebral arteriovenous fistulas (AVF) can be traumatic or spontaneous. They tend to be asymptomatic or palpation or continuous vibration in the cervical region. An arteriography is necessary for a definitive diagnosis. The treatment is complete embolization of the fistula.We present the case of a two year-old male, where the mother described it «like a washing machine in his head». On palpation during the physical examination, there was a continuous vibration, and a continuous murmur in left cervical region. A vascular malformation in vertebral region was clinically suspected, and confirmed with angio-MRI and arteriography.AVF are rare in childhood. They should be suspected in the presence of noises, palpation or continuous vibration in the cervical region. Early diagnosis can prevent severe complications in asymptomatic children

Magnetic resonance imaging findings in a case of vertebral arteriovenous fistulas in a patient of neurofibromatosis type one

Magnetic resonance imaging findings in a case of vertebral arteriovenous fistulas in a patient of neurofibromatosis type one

Retrievable Stent Technique and Coil Embolization of High-Flow Iatrogenic Cervical Vertebral Arteriovenous Fistula

Cervical vertebral arteriovenous fistulas (VAFs) are rare clinical entities between the vertebral artery and veins of the neighborhood. We report the first approach in the literature experience in the treatment of high-flow VAF caused by percutaneous catheterization of the internal jugular vein, which was successfully occluded with coils and Solitaire AB neurovascular remodeling device system that can be fully retrieved even when fully deployed for procedural control. Complete angiographic and clinical cure was achieved, and no complications related to the new embolization procedure occurred.

Spontaneous vertebral arteriovenous fistula causing cervical myelopathy and acute ischemic strokes treated by endovascular balloon–assisted coiling and Onyx embolization

Vertebral arteriovenous fistulas (VAVF) are infrequent lesions characterized by abnormal communication of the extracranial vertebral artery or one of its branches to the surrounding venous plexuses, without the presence of any intervening vessels. We describe a rare occurrence of a patient with VAVF presenting with acute ischemic stroke, encephalomalacia from multiple prior embolic events, and cervical myelopathy, which was successfully treated by coil-assisted Onyx embolization (ev3 Endovascular, Plymouth, MN, USA) with balloon for flow arrest. Our patient demonstrates that point occlusion with embolization for VAVF can be a feasible, safe, and effective treatment option for complete obliteration of the fistula, with subsequent reduction in the volume of the intra-spinal canal venous plexus. Although it is postulated that thromboembolism is less common because of redirection of flow to the venous side of the fistula, our patient also illustrates the potential for to–fro flow in such a fistula to result in embolic injury to the distal circulation.