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. 2000;10(1):35–41. doi: 10.1055/s-2000-6786

Complex Vertebral Arteriovenous Fistula and Ruptured Aneurysm in Neurofibromatosis

A Therapeutically Challenging Case

Tori C Roth, Wayne K Manness, Beverly L Hershey, Joseph Yazdi
PMCID: PMC1656747  PMID: 17171099

Abstract

The objective and importance of this study was to describe the challenges encountered with treating a high-flow vertebral arteriovenous fistula (AVF) and ruptured aneurysm in a patient with life-threatening hemorrhage. A 36-year-old female with Neurofibromatosis type 1 (NF1) presented 2 weeks after uneventful cesarean section with a rapidly expanding pulsatile neck mass. Angiography demonstrated a complex left vertebral AVF and multiple associated vertebral artery aneurysms. Emergent endovascular coil embolization was performed using a retrograde and antegrade approach to occlude the fistulas and trap the ruptured aneurysm, successfully treating the acute hemorrhage. Subsequent definitive therapy was accomplished utilizing a combined neurointerventional and neurosurgical strategy of direct-puncture acrylic embolization and ligation of the vertebral artery. Recent advances in neurointerventional technology allow novel approaches in the primary and/or preoperative treatment of complex vascular lesions such as those seen in NF1.

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These references are in PubMed. This may not be the complete list of references from this article.

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