Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures
Vertebrojugular arteriovenous fistula (VJAVF) and vertebral artery pseudoaneurysm (VAPA) are usually caused by iatrogenic and penetrating traumas. The concurrence of these two entities originating from different ostia of the vertebral artery (VA) is extremely rare. The history of repeated open-heart...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| author | Huai-Xue Mi Chun-Mei Guo Shan-Liang Chen Jun Zhang Zhi Gao Li Hongxin Ju Han |
| author_facet | Huai-Xue Mi Chun-Mei Guo Shan-Liang Chen Jun Zhang Zhi Gao Li Hongxin Ju Han |
| author_sort | Huai-Xue Mi |
| collection | DOAJ |
| description | Vertebrojugular arteriovenous fistula (VJAVF) and vertebral artery pseudoaneurysm (VAPA) are usually caused by iatrogenic and penetrating traumas. The concurrence of these two entities originating from different ostia of the vertebral artery (VA) is extremely rare. The history of repeated open-heart surgery and the application of central venous catheterization during anesthesia increased the risk of VA injuries and its complications of the VJAVF and VAPA. The patient, who complained of dizziness, was initially diagnosed with bradycardia and aortic paravalvular leak. However, the symptoms persisted even after permanent pacemaker implantation and transcatheter closure of the aortic paravalvular leak. Ultrasonography, CT angiography, and intraoperative right subclavian arteriography showed a VJAVF originating from the right VA and draining into the right internal jugular vein. A VAPA originated from another ostium of the right VA without a drainage vessel. Using the endovascular technique, a 4 mm stent graft was deployed in a 3.6 mm VA to cover both the VJAVF and the VAPA ostia. The symptoms of dizziness disappeared. The VJAVF and VAPA were completely sealed without recurrence at the 6-month follow-up. |
| format | Article |
| id | doaj-art-024f9ea5a1234346a87a1192cd50881b |
| institution | OA Journals |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-024f9ea5a1234346a87a1192cd50881b2025-08-20T01:56:42ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-04-011210.3389/fcvm.2025.14933421493342Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular proceduresHuai-Xue Mi0Chun-Mei Guo1Shan-Liang Chen2Jun Zhang3Zhi Gao4Li Hongxin5Ju Han6Department of Cardiovascular Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, ChinaDepartment of Cardiovascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, ChinaDepartment of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, ChinaDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, ChinaDepartment of Cardiovascular Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, ChinaDepartment of Neurology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, ChinaVertebrojugular arteriovenous fistula (VJAVF) and vertebral artery pseudoaneurysm (VAPA) are usually caused by iatrogenic and penetrating traumas. The concurrence of these two entities originating from different ostia of the vertebral artery (VA) is extremely rare. The history of repeated open-heart surgery and the application of central venous catheterization during anesthesia increased the risk of VA injuries and its complications of the VJAVF and VAPA. The patient, who complained of dizziness, was initially diagnosed with bradycardia and aortic paravalvular leak. However, the symptoms persisted even after permanent pacemaker implantation and transcatheter closure of the aortic paravalvular leak. Ultrasonography, CT angiography, and intraoperative right subclavian arteriography showed a VJAVF originating from the right VA and draining into the right internal jugular vein. A VAPA originated from another ostium of the right VA without a drainage vessel. Using the endovascular technique, a 4 mm stent graft was deployed in a 3.6 mm VA to cover both the VJAVF and the VAPA ostia. The symptoms of dizziness disappeared. The VJAVF and VAPA were completely sealed without recurrence at the 6-month follow-up.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1493342/fullvertebrojugular arteriovenous fistulavertebrojugular arteriovenous pseudoaneurysmendovascular therapyiatrogenic injuryvascular procedures |
| spellingShingle | Huai-Xue Mi Chun-Mei Guo Shan-Liang Chen Jun Zhang Zhi Gao Li Hongxin Ju Han Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures Frontiers in Cardiovascular Medicine vertebrojugular arteriovenous fistula vertebrojugular arteriovenous pseudoaneurysm endovascular therapy iatrogenic injury vascular procedures |
| title | Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures |
| title_full | Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures |
| title_fullStr | Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures |
| title_full_unstemmed | Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures |
| title_short | Case Report: Endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures |
| title_sort | case report endovascular therapy for an iatrogenic vertebrojugular arteriovenous fistula and pseudoaneurysm induced by multiple vascular procedures |
| topic | vertebrojugular arteriovenous fistula vertebrojugular arteriovenous pseudoaneurysm endovascular therapy iatrogenic injury vascular procedures |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1493342/full |
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