Treatment of a Spontaneous Vertebral Artery-Vertebral Vein Arteriovenous Fistula (AVF) in a Paediatric Patient

Sajjad Muhammad, Jussi Numminen, Atte Karppinen and Mika Niemelä

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Finland
Department of Neuroradiology, University of Helsinki and Helsinki University Hospital, Finland

^*Correspondance to: Sajjad Muhammad 

 PDF  Full Text DOI: 10.25107/2474-1647.2451

Abstract

Background: Extracranial vertebral artery AVF are extremely rare and there is no standardized treatment for such aneurysms. Treatment of an unruptured V1-segment vertebral artery-vertebral vein fistula in a pediatric patient has rarely been described in literature. Case
Presentation: We present a case of a 6year-old child with an incidental V1-segment vertebral artery AVF. During a routine pediatric auscultation of the heart, a bruit over the supraclavicular region was heard. Initial ultrasound showed suspicion of aneurysm of vertebral artery. CT-angiogram and DSA showed a V1-segment vertebral artery fistula. The patient was treated successfully with coil embolization. The vertebral artery was spared and reconstructed successfully during embolization without any complications. The child is now 9 years old and follow-up MRI scans in 2018 showed complete occlusion 3 years after intervention.
Conclusion: Endovascular coiling sparing vertebral artery is a safe, effective, and reliable treatment modality in pediatric cases of V1-segment vertebral artery fistula with the adjacent vein.

Keywords

V1-segment vertebral artery fistula; Coil embolization; Pediatric case

Cite the article

Muhammad S, Numminen J, Karppinen A, Niemel� M. Treatment of a Spontaneous Vertebral Artery-Vertebral Vein Arteriovenous Fistula (AVF) in a Paediatric Patient. Clin Surg. 2019; 4: 2451.