A case of paravertebral arteriovenous fistula treated bidirectionally by simultaneous transarterial and transvenous embolization

DOI Web Site 13 References Open Access
  • Wakui Daisuke
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Ito Hidemichi
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Sase Taigen
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Onodera Hidetaka
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • Oshio Kotaro
    Department of Neurosurgery, St. Marianna University School of Medicine
  • Tanaka Yuichiro
    Department of Neurosurgery, St. Marianna University School of Medicine

Bibliographic Information

Other Title
  • 経動脈ならびに経静脈の双方向同時塞栓が有効であった傍脊椎動静脈瘻の1 例
Published
2017
DOI
  • 10.3995/jstroke.10421
Publisher
The Japan Stroke Society

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Description

A 25-year-old woman with a right neck swelling visited her local hospital, where paravertebral arteriovenous fistula (PAVF) was diagnosed. The PAVF was fed mainly by the ascending cervical artery and also by the subcutaneous cervical, external cervical, and vertebral arteries, and it drained via multiple fistulas and a varix into the paravertebral venous plexus. Ligation of the main feeding artery and transarterial embolization were performed, but the PAVF recurred, so the patient was referred to our hospital, where angiography revealed multiple high-flow feeding arteries, fistulas, and draining veins. We adopted a bidirectional treatment strategy, combining transarterial and transvenous catheterization and coil embolization. The fistulas were obliterated, and 1-year follow-up angiography showed no signs of recurrence. PAVF is a rare condition involving spinal vascular malformations and for which there is no established treatment strategy. Simultaneous transarterial and transvenous embolization should be considered for PAVF with a complex angioarchitecture.

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