Arteriovenous fistula of the internal maxillary artery in a child: case report

Embolization of a congenital arteriovenous fistula of the internal maxillary artery: A case report and review of the literature

A 13 year-old girl with a congenital carotid-jugular fistula presented with a pulsatile mass and a thrill on the left side of her neck. Angiography showed a fistula between the left internal maxillary artery and the jugular vein. The patient underwent coil embolization using a transarterial balloon-assisted technique and one week later, a transvenous approach. The fistula was completely obliterated, and the patient's symptoms resolved.

Parachordal fistula – a case report and a short review

Arteriovenous shunts of the neck and facial region rarely involve the external carotid artery and its branches. Most cases are considered to be iatrogenic or related to trauma but congenital shunts are rare. Parachordal arteriovenous fistulae are a group of embryologically derived arteriovenous shunts caused by defects involving the notochord, giving rise to cranial and paraspinal shunts. In the cranial regions, these shunts involve exclusively the metameric arteries – maxillary, ascending pharyngeal, occipital and vertebral. Signs and symptoms are variable, depending on the feeding vessel but also on the characteristics of the draining pathway.

We report the case of a 17-year-old male patient with a shunt between the right internal maxillary artery and right external jugular vein detected at the age of 6, not associated with trauma, which we decided to treat because of an enlargement of the right cardiac atrium detected on routine examination. Digital subtraction angiography was performed to characterize the shunt followed by partial embolization with ballooning, coiling and Onyx injection. Echographic control 6 months after the procedure was compatible with complete occlusion of the shunt.

We also perform a short review on this extremely rare entity.

Treatment of external carotid artery fistula by percutaneous venous approach

SUMMARY

Endovascular treatment of high flow arteriovenous fistula following a stab wound injury in a 25 year old man is reported. Previously performed proximal embolisation and surgicalligation failed to occlude the fistula but resulted in changes to the normal vascular anatomy and significant clinical and cosmetic disturbances. A direct puncture of the draining vein was performed and the fistulous connection occluded by placement of detachable coils and deposition of glue. Follow-up showed disappearance of the AVF as well as complete clinical recovery.