Nageshwaran Sathiji K, Deng Francis, Regenhardt Robert W, Das Alvin S, Alotaibi Naif M, Patel Aman B, Stapleton Christopher J
Department of Neurology, Mount Sinai Hospital, New York City, NY, USA.
Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Cerebrovasc Endovasc Neurosurg. 2022 Sep;24(3):291-296. doi: 10.7461/jcen.2022.E2021.10.002. Epub 2022 May 16.
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.
椎-椎动静脉瘘（VVAVF）是罕见的疾病，其治疗缺乏共识性指南。我们的病例描述了通过对侧解构性血管内介入方法成功治疗创伤性VVAVF的过程。一名64岁女性在创伤性跌倒后就诊。计算机断层血管造影显示右椎动脉（VA）有一个2厘米的假性动脉瘤，伴有硬膜外造影剂增强，以及硬膜外间隙内有血流空洞的血肿。数字减影血管造影显示C2-3水平存在VVAVF，右椎动脉远端逆行充盈。在对右椎动脉近端剥离瓣进行多次尝试均未成功后，患者接受了对侧解构性介入方法，成功矫正了VVAVF，且未出现并发症。其余供血分支在1周后闭塞。患者在3个月的随访中完全康复，无神经后遗症。
