Endovascular management of traumatic cervicothoracic arteriovenous fistula
Date
2003
Authors
Du Toit D.F.
Leith J.G.
Strauss D.C.
Blaszczyk M.
De Odendaal J.V.
Warren B.L.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: This study evaluated a single-centre experience with endovascular repair of traumatic arteriovenous fistula in the cervicothoracic region. Methods: Endovascular repair of 27 traumatic cervicothoracic arteriovenous fistulas was attempted between August 1998 and December 2001. Patients with active bleeding or end-organ ischaemia were excluded. Follow-up was accomplished with clinical, duplex Doppler and arteriographic evaluation after 1 month and then every 3 months. Results: Twelve patients with a major vessel injury were treated by stent-graft placement. Vessels involved were the subclavian (eight), common carotid (three) and internal carotid (one) arteries. Subclavian artery side branches were embolized in three of the eight patients. Four patients developed early type 4 endoleaks but all resolved. Treatment with stent-grafts was ultimately successful in all 12 patients. Three patients were lost to follow-up. During mean follow-up of 21 (range 3-36) months, one of the remaining patients developed a graft stenosis. Fifteen patients with minor vessel injuries were treated with arterial embolization. Vessels embolized were subclavian artery branches (four), external carotid artery and branches (seven) and vertebral arteries (four). Successful embolization was accomplished in ten of 15 patients. Conclusion: Endovascular therapy is a promising alternative to surgery for selected patients with cervicothoracic arteriovenous fistula.
Description
Keywords
adolescent, adult, arteriography, arteriovenous fistula, article, artificial embolism, blood vessel injury, clinical article, common carotid artery, Doppler echography, endovascular surgery, external carotid artery, female, follow up, human, image analysis, internal carotid artery, male, outcomes research, priority journal, prosthesis failure, South Africa, stenosis, stent, subclavian artery, subclavian vein, vertebral artery, Adolescent, Adult, Arteries, Arteriovenous Fistula, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Carotid Artery Injuries, Carotid Artery, Common, Carotid Artery, Internal, Child, Embolization, Therapeutic, Female, Follow-Up Studies, Humans, Male, Neck Injuries, Stents, Treatment Outcome, Wounds, Gunshot, Wounds, Stab
Citation
British Journal of Surgery
90
12
90
12