RT Journal Article
SR Electronic
T1 Lower vertebral-epidural spinal arteriovenous fistulas: a unique subtype of vertebrovertebral arteriovenous fistula, treatable with coil and Penumbra Occlusion Device embolization
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 643
OP 647
DO 10.1136/neurintsurg-2015-011677
VO 8
IS 6
A1 Ramsey Ashour
A1 Darren B Orbach
YR 2016
UL http://jnis.bmj.com/content/8/6/643.abstract
AB A vertebral-epidural spinal arteriovenous fistula (AVF) is an abnormal arteriovenous shunt connecting the vertebral artery to the spinal epidural venous plexus, and may occur spontaneously or secondary to a variety of causes. These unique lesions are uncommon in adults and rarer still in children. Previous reports have grouped together a heterogeneous collection of such arteriovenous lesions, including arterial contributions from the upper and lower vertebral artery, with venous drainage into a variety of spinal and paraspinal collectors. Here, through two cases, we delineate a distinct entity, the lower vertebral-to-epidural AVF. The salient clinical and anatomic features are summarized and contextualized within the broader constellation of vertebrovertebral AVF, the utility of a transarterial intravenous/retrograde intra-arterial endovascular approach is highlighted, and a new use of the Penumbra Occlusion Device (Penumbra Inc) for this purpose is reported.