Sequential endovascular coil embolization for a traumatic cervical vertebral AV fistula.

An arteriovenous (AV) fistula involving the cervical vertebral artery is rare. Iatrogenic injury from percutaneous puncture and penetrating wounds are the most common causes. Symptoms include tinnitus and the presence of a pulsatile mass with a thrill. Conservative treatment with coil embolization and preservation of the vertebral artery is an alternative to surgical intervention. We report a patient who developed an AV fistula involving the vertebral artery and internal jugular vein following surgical repair of a stab wound to the neck. The sequential endovascular coil embolism was performed with subsequent successful occlusion of fistula. No neurological deficit developed during or after intervention. This approach appears to be a safe method in the treatment of vertebral AV fistula. Copyright 2003 Wiley-Liss, Inc.