Endovascular Stent-Graft Treatment of a Traumatic Vertebral Artery Pseudoaneurysm and Vertebrojugular Fistula

Sancak, Tanzer; Bilgiç, Sadık; Üstüner, Evren

doi:10.3348/kjr.2008.9.s.s68

Cited by 21 publications

(21 citation statements)

References 20 publications

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“…This review shows that endovascular treatment as a form of secondary management typically results in a favorable outcome. Reports of endovascular management for trauma-related VA injuries have shown similar results [11,32,41]. Desouza et al [11] performed a clinical review focusing on blunt VA injury and recommended that high-grade and symptomatic VA injuries be treated by endovascular approaches.…”

Section: Managementmentioning

confidence: 89%

“…If a patent contralateral VA or a sufficient collateral posterior circulation is present, direct occlusion of an injured VA is justified. However, if the patient has a hypoplastic contralateral VA, then vessel repair or stenting is preferred [18,32,37]. That said, intraoperative embolization has several limitations.…”

Section: Managementmentioning

confidence: 99%

“…Desouza et al [11] performed a clinical review focusing on blunt VA injury and recommended that high-grade and symptomatic VA injuries be treated by endovascular approaches. Endovascular techniques include stenting, VA occlusion, and coil embolization, either individually or in combination [11,32]. The choice of technique depends on the grade of the VA injury, the site of the injury, and the presence of collateral circulation and a dominant vertebral artery [5,11,32].…”

Section: Managementmentioning

confidence: 99%

“…Endovascular techniques include stenting, VA occlusion, and coil embolization, either individually or in combination [11,32]. The choice of technique depends on the grade of the VA injury, the site of the injury, and the presence of collateral circulation and a dominant vertebral artery [5,11,32]. Transvenous treatment and embolization of iatrogenic vertebral AVF have also been reported [5,16].…”

Section: Managementmentioning

confidence: 99%

“…Transvenous treatment and embolization of iatrogenic vertebral AVF have also been reported [5,16]. Some authors describe a stenting technique without coils that successfully treated a pseudoaneurysm and AVF of VA [18,32], which has the potential to assure VA patency. Although some studies report favorable outcomes for endovascular treatment, longterm studies with large sample sizes are needed to confirm long-term outcomes and complications of endovascular treatment for VA injury in ACSO.…”

Section: Managementmentioning

confidence: 99%

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The management of vertebral artery injury in anterior cervical spine operation: a systematic review of published cases

Park

Jho

2012

Eur Spine J

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Purpose Anterior cervical spine operations (ACSO) are generally considered to be safe and effective, but the vertebral artery (VA) is at risk during the procedure. Because the consequences of VA injury can be catastrophic, properly managing a VA injury is very important. However, due to the rarity of these injuries, there is no agreed upon treatment strategy. Methods Studies were identified for inclusion in the review via sensitive searches of electronic databases through 31 December 2011. All cases included in the review were qualitatively analyzed to explore the relationship between type of VA injury management and neurological complications. Results Seventeen articles describing 39 cases of VA injury during ACSO were included in this study. Seven patients (17.9 %) had neurological complications followed by VA insufficiency. Two patients (5.1 %) had root damage due to ligation. One case (2.6 %) resulted in intraoperative death due to fatal bleeding. Delayed vascular complications were identified in nine (45.0 %) of the 20 patients that underwent only tamponade or hemostatic agent during the operation. Four patients underwent intraoperative endovascular treatment, and three of these patients had a cerebral infarction. All three patients who underwent clipping also had neurological complications. The five patients treated by direct repair did not have any complications. Conclusion Our review suggests the management of VA injury should be considered in order listed: (1) performing tamponade with a hemostatic agent, (2) direct repair, (3) postoperative endovascular procedures to prevent delayed complications. If tamponade fails to achieve proper hemostasis, additional procedures as endovascular embolization, clipping and ligation should be considered but carry the risk of neurological complications. Because of the limitations of this review, further studies are recommended with larger sample sizes.

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Section: Managementmentioning

confidence: 89%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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The management of vertebral artery injury in anterior cervical spine operation: a systematic review of published cases

Park

Jho

2012

Eur Spine J

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Two cases with giant pseudo-aneurysm of vertebral artery secondary to shrapnel injury

Bayaroğulları

Yanmaz²,

Kartal

et al. 2016

Childs Nerv Syst

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Outcomes following surgical and endovascular treatment of extracranial vertebral artery aneurysms (VAA): a systematic evaluation of the literature

Akinnusotu,

Bhatti,

Ghaith

et al. 2023

Neurosurg Rev

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Extracranial vertebral artery aneurysms are rare complications from trauma and multiple diseases. However, the difference between clinical and surgical pro les is not well understood. ObjectiveTo investigate the clinical and interventional outcomes following extracranial vertebral artery aneurysms (VAA) treatment through a systematic review of the literature to date. MethodsAn electronic database search for full-text English articles was conducted following PRISMA guidelines. The search yielded results on clinical and surgical outcomes for extracranial VAAs. These results included patient-speci c risk factors, indications, and techniques. ResultsOur literature search yielded 561 articles, of which 36 studies were quali ed to be included in the analysis. A total of 55 patients with multiple various extracranial VAA incidents were included. The mean age of subjects was 42 years (ranging from 13 to 76 years), and most patients were males (71%, n = 39).Blunt trauma was the most frequent risk factor for extracranial VAA formation (35%, n = 19). The majority of aneurysms (60%) were dissecting in nature. The most common form of treatment for extracranial VAAs was a ow diverter (24%, n = 13). Overall, ve (9%) patients had long-term adverse neurological complications following intervention with 5% (n = 3) mortality, 2% (n = 1) resulting in unilateral vocal cord paralysis, and 2% (n = 1) resulting in a positive Romberg sign. The mortality rate is 15.7% in the surgical group, whereas the endovascular treatment did not result in any mortality. ConclusionThe endovascular approach is a safe and effective treatment of extracranial VAAs due to its relatively low overall complication rate and lack of resulting mortality. This contrasts with the surgical approach, which results in a higher rate of complications, recurrence, and mortality outcomes. An understanding of the factors and clinical outcomes associated with the incidence of extracranial VAAs is essential for the future improvement of patient outcomes.

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Endovascular Stent-Graft Treatment of a Traumatic Vertebral Artery Pseudoaneurysm and Vertebrojugular Fistula

Cited by 21 publications

References 20 publications

The management of vertebral artery injury in anterior cervical spine operation: a systematic review of published cases

The management of vertebral artery injury in anterior cervical spine operation: a systematic review of published cases

Two cases with giant pseudo-aneurysm of vertebral artery secondary to shrapnel injury

Outcomes following surgical and endovascular treatment of extracranial vertebral artery aneurysms (VAA): a systematic evaluation of the literature

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