Document Detail

Spontaneous resolution of an idiopathic cervical direct vertebral arteriovenous fistula after partial coil embolization in a patient presenting with myeloradiculopathy.
MedLine Citation:
PMID:  11932046     Owner:  NLM     Status:  MEDLINE    
A 53-year old female presented with paresis of the left upper extremity. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) disclosed a single high-flow vertebral arteriovenous fistula (AVF) with vertebral artery (VA) transection. The AVF was also fed by steal flow from the contralateral VA. The left posterior inferior cerebellar artery (PICA) branched just distal to the fistula. The fistula drained into the neighboring paravertebral veins and refluxed into the intradural venous systems. The dilated drainers compressed the spinal cord. Embolization was attempted at the drainer just behind the fistula orifice using platinum coils. The fistula was still fed slightly by right VA after the embolization, but spontaneous complete obliteration was achieved after one week. The clinical symptoms and signs disappeared. Although, detachable balloon embolization is the quickest and most effective procedure to obliterate a fistula, stepwise embolization using GDC can be considered, and may avoid the normal pressure perfusion break-through phenomenon. Spontaneous obliteration of the fistula after partial embolization in our case may result from intravenous embolization just behind the fistula orifice. It may therefore be a useful approach to the embolization of an AVF to begin the embolization at the venous side of the fistula.
Jun-ichiro Asai; Takaki Hayashi; Ryuta Suzuki; Tsukasa Fujimoto; Goro Nagashima
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  104     ISSN:  0303-8467     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-04-04     Completed Date:  2002-07-17     Revised Date:  2009-10-14    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  146-51     Citation Subset:  IM    
Department of Neurosurgery, Fujigaoka Hospital, School of Medicine, Showa University, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa 227-8501, Japan.
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MeSH Terms
Arteriovenous Fistula / pathology,  therapy*
Balloon Occlusion / methods*
Embolization, Therapeutic / methods*
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Middle Aged
Spinal Cord / blood supply
Treatment Outcome
Vertebral Artery / abnormalities*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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