Karatela Maham, Weissler E Hope, Cox Mitchell W, Williams Zachary F
Division of Vascular and Endovascular Surgery, Duke University School of Medicine, Durham, NC.
J Vasc Surg Cases Innov Tech. 2022 Mar 3;8(2):183-186. doi: 10.1016/j.jvscit.2022.01.009. eCollection 2022 Jun.
Traumatic vertebral artery injury is a rare, life-threatening injury that has been increasingly managed with endovascular intervention. However, an antegrade endovascular approach alone can fail to occlude traumatic pseudoaneurysms (PSAs) and arteriovenous fistulas (AVFs), requiring high-risk surgical reoperation. We have presented the case of a 27-year-old man with traumatic right vertebral artery PSA and AVF. Despite successful ipsilateral coil embolization, the PSA and AVF persisted via retrograde filling from the contralateral vertebral artery. Distal coil embolization was achieved through the contralateral vertebral artery in a novel "up and over" approach through the basilar artery. The findings from our case report have broadened the endovascular options for complicated traumatic injuries.
创伤性椎动脉损伤是一种罕见的、危及生命的损伤，目前越来越多地通过血管内介入治疗。然而，单纯的顺行血管内入路可能无法闭塞创伤性假性动脉瘤（PSA）和动静脉瘘（AVF），这就需要进行高风险的外科再次手术。我们报告了一例27岁男性创伤性右椎动脉PSA和AVF的病例。尽管同侧弹簧圈栓塞成功，但PSA和AVF通过对侧椎动脉逆行供血持续存在。通过一种新颖的经基底动脉“向上并越过”入路，经对侧椎动脉实现了远端弹簧圈栓塞。我们病例报告的结果拓宽了复杂创伤性损伤的血管内治疗选择。
