Endovascular Treatment of Vertebral Arteriovenous Fistulas
Summary
Arteriovenous fistulae (AVFs) of the vertebral artery represent abnormal shunts between the vertebral artery and perivertebral veins, leading to haemodynamic disturbances and neurological symptoms such as pulsatile tinnitus, neck mass or, rarely, spinal cord compression. Endovascular treatment has emerged as the preferred modality due to its minimally invasive nature and ability to precisely target the fistulous connection. Techniques include transarterial or transvenous approaches, employing detachable coils, liquid embolics or covered stents to achieve occlusion of the fistula while preserving normal arterial flow when possible. Treatment strategy is tailored to fistula anatomy, flow dynamics and collateral circulation, balancing complete fistula obliteration against the risk of ischaemia. Advances in imaging and device technology have improved success rates and safety profiles, allowing parent vessel preservation in selected cases and rapid symptom resolution.
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Endovascular Treatment of Vertebral Arteriovenous Fistulas publication trend
The graph below shows the total number of articles in endovascular treatment of vertebral arteriovenous fistulas across all publications each year (not limited to Nature Index journals).
Technical terms
Arteriovenous fistula: An abnormal direct connection between an artery and a vein that bypasses capillary beds, causing altered blood flow dynamics.
Endovascular embolisation: A therapeutic procedure in which occlusive materials are delivered through a catheter to block abnormal blood vessels or fistulae.
Detachable coil: A metallic helicoidal implant deployed via microcatheter to induce thrombosis within a vascular lesion.
Parent vessel sacrifice: Deliberate occlusion of the feeding artery to achieve definitive closure of a vascular abnormality when preservation is not feasible.
N-butyl cyanoacrylate (NBCA): A liquid embolic adhesive that polymerises rapidly on contact with blood to seal vascular channels.
References
- Vertebro-Vertebral Arteriovenous Fistulae: A Case Series of Endovascular Management at a Single Center. Diagnostics (2024).
- Vertebral Arteriovenous Fistula: An Unwelcome Thrill. Case Reports in Emergency Medicine (2017).
- Vertebral arteriovenous fistulae (AVF) and vertebral artery aneurysms in neurofibromatosis type 1: A case report and a systematic review. Medicine (2022).
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