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. 2007 Jun;24(2):180–196. doi: 10.1055/s-2007-980042

Figure 14.

Figure 14

A 46-year-old woman had reconstructive breast surgery as part of the treatment for breast carcinoma. She awoke with a pulsing high-pitched buzz in her right ear. Nine months of sleep disturbance ensued until the association between an abandoned right internal jugular line at the time of surgery and her symptoms was made. (A) Digital subtraction right vertebral artery angiogram shows arteriovenous fistula (AVF) (large arrow). Note the hypertrophy of the vertebral artery proximal to the AVF (small black arrows) relative to the normal distal vertebral artery (small white arrow). (B) Angiogram was repeated after occlusion of the AVF with a 6 mm × 2.5 cm vertebral artery Viabahn stent graft (Gore, Flagstaff, AZ). At 2-year follow-up the stent graft is patent with no in-stent stenosis on duplex ultrasound, and the patient remains asymptomatic.