Transvenous embolization for craniocervical junction epidural arteriovenous fistula with a pial feeder aneurysm.
Interv Neuroradiol
; 26(2): 170-177, 2020 Apr.
Article
en En
| MEDLINE
| ID: mdl-31488023
ABSTRACT
Arteriovenous fistulas at the craniocervical junction are rare vascular malformations with frequent hemorrhagic presentations, which may have a concurrent pial feeder aneurysm. A 65-year-old man presented with subarachnoid hemorrhage and angiography showed an epidural arteriovenous fistula at the C-2 level with an anterior spinal feeder aneurysm without perimedullary venous drainage. Transarterial coil embolization of the ruptured aneurysm and partial Onyx embolization of the shunt led to thrombosis of the aneurysm. However, three years later angiography showed an increased shunt flow and recurrence of the aneurysm. Transvenous embolization of the shunt using coils and Onyx yielded complete obliteration of the shunt, thus leading to occlusion of the aneurysm. This case demonstrates that partial transarterial embolization of arteriovenous fistula leaves a risk of rebleeding, whereas complete obliteration of the shunt with a transvenous approach can lead to disappearance of the flow-related aneurysm without embolization of the aneurysm itself.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Atlas Cervical
/
Cráneo
/
Venas Cerebrales
/
Aneurisma Intracraneal
/
Malformaciones Arteriovenosas Intracraneales
/
Fístula Arteriovenosa
/
Embolización Terapéutica
Límite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Interv Neuroradiol
Asunto de la revista:
NEUROLOGIA
/
RADIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Japón