Endovascular repair of subclavian artery complex pseudoaneurysm and arteriovenous fistula with coils and Onyx.
Treatment of subclavian artery pseudoaneurysm and arteriovenous fistula (AVF) can be challenging and carries a high risk of complications. Rare cases described in the literature have been managed with major surgery or endovascular treatment with stent graft placement. We present a patient with a large lobulated pseudoaneurysm of the subclavian artery and associated high-flow AVF near the left vertebral artery origin. Surgery was considered too risky and stent graft placement would have required occlusion of the vertebral artery. Successful endovascular repair was achieved with balloon-assisted selective embolization of the fistula with a combination of coils and Onyx.
Amiridze
Nana
N
Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md 21201, USA. amiridzen@gmail.com
Trivedi
Yougi
Y
Dalal
Kshitij
K
D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis / Q000628:therapy*; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000628:therapy*; D003937:Diagnosis, Differential; D004121:Dimethyl Sulfoxide / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D011145:Polyvinyls / Q000627:therapeutic use*; D013348:Subclavian Artery; D014057:Tomography, X-Ray Computed
C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide