Treatment of Traumatic Cervical Arteriovenous Fistulas with N-Butyl-2-Cyanoacrylate
M.V. Jayaramana,
H.M. Doa and
M.P. Marksa
a From the Departments of Radiology and Neurosurgery, Stanford University Medical Center, Stanford, Calif
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Fig 1. A, Lateral view from a left internal carotid angiogram demonstrates rapid filling of a large pseudoaneurysm (arrows), with subsequent drainage into the ipsilateral sigmoid sinus (curved arrow) and retrograde opacification of the superior ophthalmic veins (arrowheads). Note the lack of any opacification of normal carotid artery distal to the site of the fistula.
B, Lateral view from left common carotid artery angiogram after treatment of the carotid cavernous fistula (data not shown) and after glue embolization of the distal cervical ICA demonstrates a small amount of residual filling of the pseudoaneurysm (arrows) from a branch of the left internal maxillary artery (arrowhead).
C, Lateral view, left common carotid angiogram after embolization of the internal maxillary artery branch demonstrates no further filling of the pseudoaneurysm or the fistula.
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Fig 2. A, Frontal projection from a right subclavian artery angiogram demonstrates a rapidly filling fistula (arrowhead) between the right vertebral artery (arrow) and the right internal jugular vein (curved arrow). Similar to Fig 1, note the lack of filling of the vertebral artery distal to the fistula.
B, Frontal projection, right subclavian artery angiogram after glue embolization demonstrates no further filling of the fistula.
C, Venous phase image from a left vertebral artery angiogram demonstrates a widely patent right internal jugular vein (curved arrow). Note the glue cast in the right vertebral artery (arrow).
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AJNR - American Journal of Neuroradiology