Successful stent-graft repair of a vertebrojugular arteriovenous fistula.
OBJECTIVE
To describe an apparently unreported endovascular means of treating a vertebral arteriovenous fistula (AVF) using a small-caliber stent-graft to permanently reconstruct the involved vessels.


METHODS
A 13-year-old girl presented with tinnitus caused by a high-flow AVF between the right extracranial vertebral artery and deep jugular vein arising from repeated internal jugular vein catheterization. A 4-mm-diameter balloon-expandable Jostent coronary stent-graft was placed in the vertebral artery via a percutaneous femoral access, with immediate and complete obliteration of the AVF and resolution of the tinnitus. Follow-up duplex ultrasonography at 15 months demonstrated patency and luminal integrity of the vertebral artery.


CONCLUSIONS
Vertebrojugular AVFs are rare and usually treated with transcatheter embolization techniques, but percutaneous repair using a small-caliber stent-graft appears feasible. This minimally invasive treatment might become the method of choice for AVFs in other small-bore vessels.
Rückert
R I
RI
Departments of Surgery, Humboldt University Medical School, Berlin, Germany. Ralph-i.rueckert@charite.de
Rutsch
W
W
Filimonow
S
S
Lehmann
R
R
D001164:Arteriovenous Fistula / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002648:Child; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow / Q000502:physiology; D015607:Stents; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000503:physiopathology / Q000601:surgery*