Transvenous embolization for vertebral arteriovenous fistula: report of two cases and technical notes.

BACKGROUND: Vertebral arteriovenous fistulas are relatively rare. Although the common treatment is transarterial embolization, it may be impossible to pass through the fistula (e.g. a microfistula created by a needle puncture). We report two patients with vertebral arteriovenous fistulas due to penetrating trauma who were successfully treated by transvenous embolization.

METHOD: We present 2 patients with vertebral arteriovenous fistulas. One patient is presented to demonstrate complications following attempted internal jugular cannulation and the other is presented to demonstrate complications after surgery for a jugular foramen neurinoma. Both patients manifested the sign of a severe bruit.

FINDINGS: To identify the fistula point, simultaneous transarterial and transvenous angiography was performed. Using the transvenous approach, microcoils were applied to the fistula and the bruit completely disappeared. Interpretation. Transvenous embolization is a useful technique and a first-choice strategy to treat patients with the vertebral arteriovenous fistula due to penetrating trauma.