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Pediatric Iatrogenic Vertebral Arteriovenous Fistula Successfully Treated with Endovascular Treatment:A Case Report Rintaro YOKOYAMA 1 , Satoshi IIHOSHI 1 , Kei MIYATA 1 , Kentaro TOYAMA 1 , Katsuya KOMATSU 1 , Masahiko WANIBUCHI 1 , Nobuhiro MIKUNI 1 1Department of Neurosurgery, Sapporo Medical University School of Medicine Keyword: iatrogenic vertebral artery injury , arteriovenous fistula , endovascular treatment , hydrogel coil pp.857-861
Published Date 2016/10/10
DOI https://doi.org/10.11477/mf.1436203390
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 OBJECT:We report a relatively rare case of pediatric iatrogenic extradural vertebral arteriovenous fistula.

 CASE:A five-year-old boy with a history of multiple surgeries for Total Anomalous Pulmonary Venous Return(TAPVR)exhibited vascular engorgement of his right neck from about 4 years old. We thought that this was caused by his past operations. He demonstrated swollen blood vessels in the right neck and pulmonary hypertension with increased right heart load. A right extradural vertebral arteriovenous fistula was seen on angiography. A high flow shunt was present at the V1 segment, at the level of the sixth cervical vertebra, and a 12 mm venous pouch was present anterior to the vertebral artery. We recognized the outlet passages of the cranial tract were the vertebral venous plexus, internal jugular vein, and right atrium. We performed endovascular transarterial embolization using a hydrogel coil. As a result, we treated with a high volume embolization ratio. Following treatment, the arteriovenous fistula disappeared while anterograde blood flow of the vertebral artery was preserved. The patient demonstrated no neurological deficits, improved right heart load, and his venous pouch of the neck. He has had no recurrence in the two years after treatment.

 CONCLUSION:Endovascular surgery is effective and safe for the treatment of iatrogenic vertebral arteriovenous fistula.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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