A Successful Hybrid Repair for Vertebral Arteriovenous Fistula with Extracranial Vertebral Artery Aneurysm

A 40-year-old female presented with general fatigue. Echocardiography and computed tomography revealed a cervical vertebral arteriovenous fistula (VAF) with an extracranial vertebral artery aneurysm (VAA). She had closure of an atrial septal defect via right jugular vein catheterization at 5 years of age. Considering the anatomical location, a hybrid endovascular and surgical procedure was successfully performed to exclude both the VAF and VAA from the arterial circulation. This procedure may be considered an alternative to treat vertebral arterial pathology.