Onyx embolization of high-flow spontaneous cervical vertebral arteriovenous fistula.
BACKGROUND
High-flow spontaneous vertebral arteriovenous shunts in patients with fibromuscular disease (FMD) are rare. Onyx embolization of the recipient veins with shunt disconnection and preservation of the affected vertebral artery in a patient with FMD has not been reported.


METHODS
A 59-year-old female presented with progressive dizziness, pre-syncopal episodes, and tinnitus. Catheter-based angiography identified features of fibromuscular dysplasia and a high-flow right cervical vertebral artery arteriovenous shunt. Onyx embolization of the principle draining veins was performed with initial detachable coil placement. Complete disconnection of the shunt was achieved without sacrifice of the parent vertebral artery.


CONCLUSIONS
Spontaneous high-flow vertebral arteriovenous shunts can be successfully occluded with Onyx/detachable coil embolization of the principle recipient veins.
Department of Neurointerventional Radiology, St Joseph Medical Center, IL 61701, USA. gordhana@gmail.com
Ajeet
A
Gordhan
D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001783:Blood Flow Velocity; D002574:Cervical Vertebrae / Q000098:blood supply*; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004621:Embolization, Therapeutic; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage*; D012039:Regional Blood Flow; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*
C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide