Endovascular treatment of vertebral artery steal syndrome from an arteriovenous fistula between the internal mammary artery and superior vena cava.
Vertebrobasilar insufficiency resulting from subclavian steal syndrome and high flow through hemodialysis fistulas has been described. The present report describes a case of vertebral artery steal syndrome from an arteriovenous (AV) fistula between the right internal mammary artery and superior vena cava with the unusual pattern of antegrade flow through the vertebral artery in the setting of classic symptoms of steal. The AV fistula likely developed during earlier cardiac catheterizations. The patient presented with progressively worsening gait and limb ataxia. Angiography demonstrated the AV fistula and antegrade flow through the vertebral artery. Coil embolization of this high-flow fistula resulted in complete resolution of symptoms.
Huang
Jessica S
JS
Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, Missouri 63110, USA.
Picus
Daniel
D
Brown
Daniel B
DB
D000293:Adolescent; D001027:Aortography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects; D004621:Embolization, Therapeutic; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D013349:Subclavian Steal Syndrome / Q000150:complications / Q000503:physiopathology; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000503:physiopathology; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014927:Wolff-Parkinson-White Syndrome / Q000601:surgery