Successful stent-graft repair of a vertebrojugular arteriovenous fistula

Purpose: To describe an apparently unreported endovascular means of treatin g a vertebral arteriovenous fistula (AVF) using a small-caliber stent-graft to permanently reconstruct the involved vessels. Case Report. A 13-year-old girl presented with tinnitus caused by a high-fl ow AVF between the right extracranial vertebral artery and deep jugular vei n arising from repeated internal jugular vein catheterization. A 4-mm-diame ter balloon-expandable Jostent coronary stent-graft was placed in the verte bral artery via a percutaneous femoral access, with immediate and complete obliteration of the AVF and resolution of the tinnitus. Follow-up duplex ul trasonography at 15 months demonstrated patency and luminal integrity of th e vertebral artery. Conclusions: Vertebrojugular AVFs are rare and usually treated with transca theter embolization techniques, but percutaneous; repair using a small-cali ber stent-graft appears feasible. This minimally invasive treatment might b ecome the method of choice for AVFs in other small-bore vessels.