Nakstad P H, Haakonsen M, Magnaes B, Hetland S
Department of Neuroradiology, Ullevaal University Hospital, Oslo, Norway.
Acta Radiol. 1997 Jan;38(1):25-9. doi: 10.1080/02841859709171237.
A 7-year-old girl with a right-sided congenital arteriovenous fistula in the neck was admitted with signs of cardial incompensation. Her fistula was fed from the right vertebral artery in antegrade as well as retrograde directions. A steal from the intracranial arteries was established. In addition, smaller feeding arteries from the neck were found. She was operated on with ligation of the right vertebral artery proximal to the fistula but the attempted ligation of the artery cranially to the fistula was unsuccessful. She was therefore embolized by the formation of a plug of platinum fiber coils in the upper right vertebral artery. Catheterization was performed from the left vertebral artery via the basilar artery. Persisting minor feeders to the fistula from cervical arteries were embolized in a second session. Finally, surgical extirpation of the fistula was performed together with the operative ligation of a crossover feeding artery from the left vertebral artery. Her heart size, heart rate and blood pressure were successively normalized.
一名7岁女童因颈部右侧先天性动静脉瘘入院，伴有心功能不全症状。她的瘘管由右侧椎动脉顺行和逆行供血。已证实存在颅内动脉盗血现象。此外，还发现了来自颈部的较小供血动脉。对她进行了手术，在瘘管近端结扎右侧椎动脉，但试图在瘘管上方结扎该动脉未成功。因此，通过在右上椎动脉中形成铂纤维线圈栓塞物对她进行了栓塞治疗。通过左椎动脉经基底动脉进行插管。在第二次治疗中，对来自颈动脉的持续存在的较小瘘管供血支进行了栓塞。最后，对瘘管进行了手术切除，并对来自左椎动脉的交叉供血动脉进行了手术结扎。她的心脏大小、心率和血压相继恢复正常。
