Arteriovenous Vertebral Fistulae Cure by Combination of Operation and Detachable Intravascular Balloon

Abstract

The direct surgical treatment of vertebral arteriovenous fistulae (AVF) presents serious difficulty and risk. Techniques for intravascular occlusion or embolization have made the treatment of AVF safer and effective. However, the occlusion of an AVF involving the segment where the vertebral vein becomes a single vessel may result in pulmonary emoblization by the occluding material. A combined procedure involving ligation of the vertebral vein and detachable balloon occlusion of the fistula was used in two instances without complications and with complete cure of the AVF.

Surgical reconstruction of the extracranial vertebral artery: Management and outcome

“…The role of endovascular treatment of ECVA lesions is modest and limited to the occlusion of arteriovenous fistulas with detachable balloons. 15 In proximal ECVA disease, the combined death/stroke rate since 1991 has been nil and the average length of stay is 24 hours. It is unlikely that this outcome can be improved with endovascular techniques.…”

Treatment of vertebral arteriovenous fistulas

“…In an attempt to minimize the hemorrhage during surgical exposure, several techniques have been employed, including temporary occlusion of the fistula site with angioplasty catheters [31] , intraoperative placement of balloon catheters at the fistula site, and hypotensive anesthesia [30]. Combined surgical and balloon embolization techniques have been used to complete trapping procedures [32][33][34]. More recently , trapping procedures with detachable balloons and balloon embolization with preservation of vertebral flow have been described [35][36][37] .…”

Spontaneous Vertebrovertebral Arteriovenous Fistula Treated by Steel Coil Embolization: Case Report

“…Different techniques for intravascular occlusion with or without concomitant surgery have been described. 12.I3 Although potential complications such as embolization in the arterial system or in the lungs, perforation, and distal thrombosis are theoretically possible, the increase success of interventional angiography, especially for posttraumatic embolization of the vertebral artery, led us to perform this type of procedure in our case. …”