Endovascular treatment of traumatic injuries of the vertebral artery.
OBJECTIVE
There are a few reports regarding the treatment of traumatic vertebral arteriovenous fistulas and pseudoaneurysms. Our aim was to describe the clinical and angiographic results of endovascular therapy for traumatic injuries of the vertebral artery.


METHODS
The clinical and angiographic features of 18 traumatic injuries of the vertebral artery during an 8-year period were reviewed. There were 14 male (78%) and 4 female patients (22%). The average age was 28 years (range, 11-49 years). Of the 18 lesions of the vertebral artery, 17 (95%) were the result of penetrating trauma (gunshot or stab wound injury) and 1 (5%) was iatrogenic (jugular vein catheter). In 16 (89%) instances, the injury resulted in an arteriovenous fistula, and in the other 2 (11%), in a pseudoaneurysm. All patients were treated with an endovascular approach by using different techniques (balloon occlusion, coil embolization, and/or stent deployment).


RESULTS
Endovascular therapy resulted in immediate lesion total occlusion in 16 (89%) patients. Delayed total occlusion was demonstrated angiographically during follow-up in the 2 remaining patients. Clinical improvement was documented in all patients, and there were no clinically symptomatic complications.


CONCLUSIONS
In this small series, endovascular techniques were a safe and effective method of treatment and were not associated with significant morbidity or mortality.
Herrera
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Department of Radiology, Neuroradiology Section, Universidad de Antioquia, Hospital Universitario San Vicente de Paul, Medellin, Colombia. herrera.diego@gmail.com
Vargas
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Dublin
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D000293:Adolescent; D000328:Adult; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000293:injuries*; D014950:Wounds, Penetrating / Q000628:therapy*