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- Title
Anatomically Based Approach for Endovascular Treatment of Vertebro-Vertebral Arteriovenous Fistula.
- Authors
CHIH-HUA YEH; YAO-LIANG CHEN; YI-MING WU; YU-CHIEH HUANG; HO-FAI WONG
- Abstract
Vertebro-vertebral arteriovenous fistula (VVAVF) is a rare vascular disorder with an abnormal high-flow shunt between the extracranial vertebral artery (VA), its muscular or radicular branches and an adjacent vein. To date, there are no guidelines on the best treatment for VV-AVF. We present our experience of VV-AVF treatment with covered stents in three patients and detachable coils in two patients. One patient with fistula at the V3 segment had rapid fistula recurrence one week after covered stent treatment. The possible causes of failed treatment in this patient are discussed. The currently available treatment modalities for VV-AVF are also summarized after a literature review. At the end of this article, we propose a new concept of anatomically based approach for endovascular treatment of VV-AVF. Fistula in the V1-2 segments of vertebral artery could be treated safely and effectively by covered stent with the benefit of preserving VA patency. Embolization with variable embolizers should be considered first for fistula in the V3 segment because of the tortuous course and flexibility of the VA in this segment.
- Subjects
VERTEBRAL artery; ARTERIOVENOUS fistula; THERAPEUTIC embolization; SURGICAL stents; HUMAN abnormalities
- Publication
Interventional Neuroradiology, 2014, Vol 20, Issue 6, p766
- ISSN
1591-0199
- Publication type
Article
- DOI
10.15274/INR-2014-10072