Anterior condylar arteriovenous fistula mainly fed by peripheral branches of the bilateral internal maxillary arteries: illustrative case.
anterior condylar
arteriovenous fistula
embolization
maxillary artery
sphenopalatine artery
Journal
Journal of neurosurgery. Case lessons
ISSN: 2694-1902
Titre abrégé: J Neurosurg Case Lessons
Pays: United States
ID NLM: 9918227275606676
Informations de publication
Date de publication:
09 10 2023
09 10 2023
Historique:
received:
15
08
2023
accepted:
06
09
2023
medline:
1
11
2023
pubmed:
1
11
2023
entrez:
1
11
2023
Statut:
epublish
Résumé
The main feeding artery of an anterior condylar arteriovenous fistula (AC-AVF) is the ascending pharyngeal artery and rarely the internal maxillary artery. A 58-year-old male with a history of sinusitis since adolescence presented with a 5-year history of bilateral pulsatile tinnitus and a 2-month history of right ocular symptoms. Angiography showed that the peripheral branches of the bilateral internal maxillary arteries were the main feeding arteries of the AC-AVF and that they gathered in the clivus with a relatively large shunted pouch in the left jugular tubercle. Shunt flow drained to the right external jugular vein via the right superior ophthalmic vein. A sheath was placed in the right external jugular vein, and a small distal access catheter was guided to the right superior ophthalmic vein to allow the microcatheter to reach the shunted pouch. Selective angiography of the contralateral sphenopalatine artery allowed us to confirm the gathering site of the feeding arteries and the shunted pouch and archive the complete occlusion. Selective angiography of the contralateral sphenopalatine artery may be useful to confirm the gathering site of the peripheral branches of the bilateral internal maxillary arteries in an AC-AVF.
Sections du résumé
BACKGROUND
The main feeding artery of an anterior condylar arteriovenous fistula (AC-AVF) is the ascending pharyngeal artery and rarely the internal maxillary artery.
OBSERVATIONS
A 58-year-old male with a history of sinusitis since adolescence presented with a 5-year history of bilateral pulsatile tinnitus and a 2-month history of right ocular symptoms. Angiography showed that the peripheral branches of the bilateral internal maxillary arteries were the main feeding arteries of the AC-AVF and that they gathered in the clivus with a relatively large shunted pouch in the left jugular tubercle. Shunt flow drained to the right external jugular vein via the right superior ophthalmic vein. A sheath was placed in the right external jugular vein, and a small distal access catheter was guided to the right superior ophthalmic vein to allow the microcatheter to reach the shunted pouch. Selective angiography of the contralateral sphenopalatine artery allowed us to confirm the gathering site of the feeding arteries and the shunted pouch and archive the complete occlusion.
LESSONS
Selective angiography of the contralateral sphenopalatine artery may be useful to confirm the gathering site of the peripheral branches of the bilateral internal maxillary arteries in an AC-AVF.
Identifiants
pubmed: 37910008
doi: 10.3171/CASE23452
pii: CASE23452
pmc: PMC10566522
doi:
pii:
Types de publication
Journal Article
Langues
eng
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