Transvenous embolization for vertebral arteriovenous fistula: Report of two cases and technical notes

Background. Vertebral arteriovenous fistulas are relatively rare. Although the common treatment is transarterial embolization, it may be impossible to pass through the fistula (e.g. a microfistula created by a needle puncture ). We report two patients with vertebral arteriovenous fistulas due to pene trating trauma who were successfully treated by transvenous embolization. Method. We present 2 patients with vertebral arteriovenous fistulas. One pa tient is presented to demonstrate complications following attempted interna l jugular cannulation and the other is presented to demonstrate complicatio ns after surgery for a jugular foramen neurinoma. Both patients manifested the sign of a severe bruit. Findings. To identify the fistula point, simultaneous transarterial and tra nsvenous angiography was performed. Using the transvenous approach, microco ils were applied to the fistula and the bruit completely disappeared. Inter pretation. Transvenous embolization is a useful technique and a first-choic e strategy to treat patients with the vertebral arteriovenous fistula due t o penetrating trauma.