Advanced

AJNR - American Journal of Neuroradiology

Publication Preview: Published May 22, 2008

American Journal of Neuroradiology 2008;29:1585.

This Article Full Text (PDF) All Versions of this Article: ajnr.A1123v1 29/8/1585    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Herrera, D.A. Articles by Dublin, A.B. Search for Related Content PubMed PubMed Citation Articles by Herrera, D.A. Articles by Dublin, A.B.

American Journal of Neuroradiology
DOI 10.3174/ajnr.A1123

INTERVENTIONAL

Endovascular Treatment of Traumatic Injuries of the Vertebral Artery

D.A. Herrera, S.A. Vargas and A.B. Dublin

From the Department of Radiology (D.A.H., S.A.V.), Neuroradiology Section, Universidad de Antioquia, Hospital Universitario San Vicente de Paul, Medellin, Colombia; and Department of Radiology (A.B.D.), Neuroradiology Section, UC Davis Medical Center, Sacramento, Calif.

Please address correspondence to Diego A. Herrera, MD, Department of Radiology, Neuroradiology Section, Universidad de Antioquia, Hospital Universitario San Vicente de Paul, Medellin, Colombia; e-mail: herrera.diego{at}gmail.com

BACKGROUND AND PURPOSE: There are a few reports regarding the treatment of traumatic vertebral arteriovenous fistulas and pseudoaneurysms. Our aim was to describe the clinical and angiographic results of endovascular therapy for traumatic injuries of the vertebral artery.

MATERIALS AND METHODS: The clinical and angiographic features of 18 traumatic injuries of the vertebral artery during an 8-year period were reviewed. There were 14 male (78%) and 4 female patients (22%). The average age was 28 years (range, 11–49 years). Of the 18 lesions of the vertebral artery, 17 (95%) were the result of penetrating trauma (gunshot or stab wound injury) and 1 (5%) was iatrogenic (jugular vein catheter). In 16 (89%) instances, the injury resulted in an arteriovenous fistula, and in the other 2 (11%), in a pseudoaneurysm. All patients were treated with an endovascular approach by using different techniques (balloon occlusion, coil embolization, and/or stent deployment).

RESULTS: Endovascular therapy resulted in immediate lesion total occlusion in 16 (89%) patients. Delayed total occlusion was demonstrated angiographically during follow-up in the 2 remaining patients. Clinical improvement was documented in all patients, and there were no clinically symptomatic complications.

CONCLUSION: In this small series, endovascular techniques were a safe and effective method of treatment and were not associated with significant morbidity or mortality.