title: [Pediatric Iatrogenic Vertebral Arteriovenous Fistula Successfully Treated with Endovascular Treatment:A Case Report].
abstract: OBJECTIVE
  We report a relatively rare case of pediatric iatrogenic extradural vertebral arteriovenous fistula.
  
  
  METHODS
  A five-year-old boy with a history of multiple surgeries for Total Anomalous Pulmonary Venous Return(TAPVR)exhibited vascular engorgement of his right neck from about 4 years old. We thought that this was caused by his past operations. He demonstrated swollen blood vessels in the right neck and pulmonary hypertension with increased right heart load. A right extradural vertebral arteriovenous fistula was seen on angiography. A high flow shunt was present at the V1 segment, at the level of the sixth cervical vertebra, and a 12 mm venous pouch was present anterior to the vertebral artery. We recognized the outlet passages of the cranial tract were the vertebral venous plexus, internal jugular vein, and right atrium. We performed endovascular transarterial embolization using a hydrogel coil. As a result, we treated with a high volume embolization ratio. Following treatment, the arteriovenous fistula disappeared while anterograde blood flow of the vertebral artery was preserved. The patient demonstrated no neurological deficits, improved right heart load, and his venous pouch of the neck. He has had no recurrence in the two years after treatment.
  
  
  CONCLUSIONS
  Endovascular surgery is effective and safe for the treatment of iatrogenic vertebral arteriovenous fistula.
authors.affiliation: Department of Neurosurgery, Sapporo Medical University School of Medicine.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Yokoyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iihoshi
authors.forename: Kei
authors.initials: K
authors.lastname: Miyata
authors.forename: Kentaro
authors.initials: K
authors.lastname: Toyama
authors.forename: Katsuya
authors.initials: K
authors.lastname: Komatsu
authors.forename: Masahiko
authors.initials: M
authors.lastname: Wanibuchi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Mikuni
mesh_terms: D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D007049:Iatrogenic Disease; D021621:Imaging, Three-Dimensional; D008297:Male; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging