Lu Yu-Chun, Wen Chung-Yu, Yang Shun-Tai, Lu Yueh-Hsun, Su I-Chang
Department of Neurosurgery, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei City, Taiwan.
Division of Neurosurgery, Department of Surgery, Maioli General Hospital, Maioli County, Taiwan.
J Surg Case Rep. 2021 Aug 13;2021(8):rjab334. doi: 10.1093/jscr/rjab334. eCollection 2021 Aug.
Vertebro-venous fistula (VVF) refers to an abnormal arteriovenous shunt connecting the extracranial vertebral artery and the paraspinal venous structures. Coil embolization is the mainstay treatment of choice for VVF, and accurate definition of the endovascular target is mandatory. Traditionally, catheter-based angiograms are used for treatment planning, but those images lack bony information to delineate the precise relationship of the drainage veins to the spinal structure. Herein, we presented two VVF cases and demonstrated how we used intra-arterial cone-beam computed tomography angiography (IA-CBCTA) to determine the safe embolization zone for dense coil packing. We propose that IA-CBCTA is a useful adjunct in the endovascular planning of VVF by offering an image consisting of bony and vascular information.
椎静脉瘘（VVF）是指连接颅外椎动脉和椎旁静脉结构的异常动静脉分流。弹簧圈栓塞是VVF的主要治疗选择，准确界定血管内治疗靶点至关重要。传统上，基于导管的血管造影用于治疗规划，但这些图像缺乏骨信息，无法描绘引流静脉与脊柱结构的精确关系。在此，我们展示了两例VVF病例，并演示了如何使用动脉内锥束计算机断层扫描血管造影（IA-CBCTA）来确定密集弹簧圈填充的安全栓塞区域。我们认为，IA-CBCTA通过提供包含骨和血管信息的图像，在VVF的血管内治疗规划中是一种有用的辅助手段。
