PDF(Pubmed)
Abstract：
UNASSIGNED: Direct vertebrovertebral fistulas (VVFs) involving the V3 segment of the vertebral artery (VA) are rare. Endovascular treatment (EVT) can be used to obliterate these VVFs.
METHODS: Case 1 was a 30-year-old male with limb weakness. He had grade V muscle strength in his limbs. Angiography confirmed a low-flow direct VVF of the V3 segment. The right VA was well developed. Coiling of the VVF and its parent VA obliterated the VVF. The vertebrobasilar arteries had sufficient blood from the right VA. Postoperatively, the patient recovered well. Case 2 was a 51-year-old male with headache and weakness of the limbs. He had grade IV muscle strength in his limbs. Angiography revealed a high-flow direct VVF in the V3 segment. The left VA was well developed. Coiling of the VVF and its parent VA obliterated the VVF. The vertebrobasilar arteries had sufficient blood from the left VA. Postoperatively, the patient recovered well.
UNASSIGNED: Direct VVF of the V3 segment is difficult to treat, and EVT, including reconstructive and deconstructive approaches, can be an effective treatment option. According to this case report and literature review, reconstructive EVT is ideal; however, it is difficult to perform. Currently, deconstructive EVT may be the mainstream option for treating direct VVF of the V3 segment.
CONCLUSIONS: In certain cases where the contralateral VA is well developed, coiling the fistula and the parent VA is still an effective treatment.
METHODS: Case 1 was a 30-year-old male with limb weakness. He had grade V muscle strength in his limbs. Angiography confirmed a low-flow direct VVF of the V3 segment. The right VA was well developed. Coiling of the VVF and its parent VA obliterated the VVF. The vertebrobasilar arteries had sufficient blood from the right VA. Postoperatively, the patient recovered well. Case 2 was a 51-year-old male with headache and weakness of the limbs. He had grade IV muscle strength in his limbs. Angiography revealed a high-flow direct VVF in the V3 segment. The left VA was well developed. Coiling of the VVF and its parent VA obliterated the VVF. The vertebrobasilar arteries had sufficient blood from the left VA. Postoperatively, the patient recovered well.
UNASSIGNED: Direct VVF of the V3 segment is difficult to treat, and EVT, including reconstructive and deconstructive approaches, can be an effective treatment option. According to this case report and literature review, reconstructive EVT is ideal; however, it is difficult to perform. Currently, deconstructive EVT may be the mainstream option for treating direct VVF of the V3 segment.
CONCLUSIONS: In certain cases where the contralateral VA is well developed, coiling the fistula and the parent VA is still an effective treatment.
摘要：
■涉及椎动脉（VA）V3段的直接椎管瘘（VVFs）很少见。血管内治疗(EVT)可用于消除这些VVF。
方法：病例1是一名30岁男性，肢体无力。他四肢有V级肌肉力量。血管造影证实了V3段的低流量直接VVF。正确的VA得到了很好的发展。VVF及其父VA的卷绕消除了VVF。椎基底动脉从右侧VA有足够的血液。术后,病人恢复得很好。病例2是一名51岁的男性，患有头痛和四肢无力。他的四肢有IV级肌肉力量。血管造影显示V3段有高流量直接VVF。左VA发育良好。VVF及其父VA的卷绕消除了VVF。椎基底动脉从左VA有足够的血液。术后,病人恢复得很好。
■V3段的直接VVF难以治疗，和EVT,包括重建和解构方法，可以是一种有效的治疗选择。根据该病例报告和文献复习,重建EVT是理想的；然而，很难执行。目前,解构性EVT可能是治疗V3段直接VVF的主流选择。
结论：在某些情况下，对侧VA发育良好，盘绕瘘管和母体VA仍然是一种有效的治疗方法。
方法：病例1是一名30岁男性，肢体无力。他四肢有V级肌肉力量。血管造影证实了V3段的低流量直接VVF。正确的VA得到了很好的发展。VVF及其父VA的卷绕消除了VVF。椎基底动脉从右侧VA有足够的血液。术后,病人恢复得很好。病例2是一名51岁的男性，患有头痛和四肢无力。他的四肢有IV级肌肉力量。血管造影显示V3段有高流量直接VVF。左VA发育良好。VVF及其父VA的卷绕消除了VVF。椎基底动脉从左VA有足够的血液。术后,病人恢复得很好。
■V3段的直接VVF难以治疗，和EVT,包括重建和解构方法，可以是一种有效的治疗选择。根据该病例报告和文献复习,重建EVT是理想的；然而，很难执行。目前,解构性EVT可能是治疗V3段直接VVF的主流选择。
结论：在某些情况下，对侧VA发育良好，盘绕瘘管和母体VA仍然是一种有效的治疗方法。
