Deconstructive repair of a traumatic vertebrovertebral arteriovenous fistula via a contralateral endovascular approach
10.7461/jcen.2022.E2021.10.002
- Author:
Sathiji K. NAGESHWARAN
1
;
Francis DENG
;
Robert W. REGENHARDT
;
Alvin S. DAS
;
Naif M. ALOTAIBI
;
Aman B. PATEL
;
Christopher J. STAPLETON
Author Information
1. Department of Neurology, Mount Sinai Hospital, New York City, NY, USA
- Publication Type:Case Report
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2022;24(3):291-296
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
