Long-term follow-up of craniovertebral junction arteriovenous fistulas surgically treated by feeder obliteration: report of three cases.
Craniovertebral junction arteriovenous fistulas are still rare and are viewed differently from other arteriovenous fistulas because of their specificity of location and treatment. Intravascular treatment has come to play an important role in this area, but it is still controversial in terms of safety and reliability for complete obliteration. From the anatomical point of view, direct surgery seems to be more efficient and safe than endovascular therapy based on our experience with three surgically treated cases. In all three cases, the surgical approach was intended to obliterate the feeders in the vicinity of the nidus. In 2 of 3 cases, follow-up angiography showed complete obliteration of the fistulas and one case showed partial obliteration. No recurrence of symptoms was encountered 4-7 years postoperatively. Surgical treatment is still advantageous over intravascular treatment in this type of arteriovenous malformation. Simple surgical fistulous obliteration may lead to the gradual complete disappearance of this malformation.
Morimoto
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Department of Neurosurgery, Nara Medical University, Kashihara, Japan.
Matsuyama
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Sakaki
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