[Successful trans-arterial occlusion of a vertebral arteriovenous fistula with aid of intra vascular ultra sound (IVUS) and balloon catheter].

We report a case of spontaneous vertebral arteriovenous fistula manifesting pulsating tinnitus with left cervical bruit. A 50-year-old woman presented with pulsatile tinnitus of unknown duration. Angiography revealed a simple and direct fistula between the second segment of the left vertebral artery and the epidural venous system. The fistula was well visualized by intra vascular ultra sound (IVUS). Balloon catheters were used for regulating blood flow during coil embolization, which successfully obliterated the fistula, with subsequent control of the symptoms. Postoperative course (18 months) was uneventful.