Vertebral arteriovenous fistulas following insertion of central monitoring catheters

Abstract

Iatrogenic vertebral arteriovenous fistulas were first reported in 1963. Since then, 20 additional cases have been reported--all following angiographic procedures. We report herein the first recognized cases of such fistulas resulting from percutaneous internal jugular and subclavian venous catheterizations performed for routine hemodynamic monitoring. The symptoms of late-occurring cervical bruit and thrill were identical to those described previously, although the ability to obliterate the thrill by pressure on the common carotid artery in one patient was inconsistent with other experience. These two patients were treated by direct ligation of the fistulous communication, after careful preoperative localization by angiography. Both patients have had complete disappearance of the symptoms and signs of the fistulas.