sessions. During imaging workup, a magnetic resonance angiography (MRA) of the head and neck demonstrated an AVF between the left distal cervical VA and the left paravertebral plexus, at the level of C2. Results Dual lumen balloon catheters allowed for localization of the fistula point as well as assistance for coil embolization. In both cases the balloon was inflated with angiograms performed proximal or around the balloon to locate and isolate the VA segment containing the fistula.

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... , temporary vessel occlusion was useful not only to find the fistulous rent but also to reduce the venous outflow and maintain flow control during coiling. Complete closure of the VV-AVF was obtained in both cases, with rapid improvement in clinical outcome. Conclusions VV-AVF dual lumen balloon-assisted coiling is a feasible solution both in adult and pediatric patients. Temporary balloon inflation in the fistula helps to locate the fistulous point, to isolate the segment of the fistula preventing coil protrusion in the parent vertebral artery, to reduce the venous outflow and maintain flow control during coiling. The use of dual lumen balloon catheter allow for maintenance of patency of the vertebral artery and targeted coil embolization at the fistula point resulting in angiographic cure for both cases.