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Endovascular embolisation as minimally-invasive treatment for spinal dural arteriovenous fistulas — evaluation of long-term results
Affiliations- Department of Neurosurgery, Medical University of Lublin, Lublin, Poland
- Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
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Abstract
Aim of study. Spinal dural arteriovenous fistulas (sDAVF) are rare spinal cord lesions formed between a radicular artery and medullary vein leading to venous hypertension resulting in neurological impairment. Endovascular embolisation is a minimally-invasive method aiming to interrupt the shunt between the artery and vein. We report our experience with sDAVF treated endovascularly.
Material and methods. Clinical and procedural data of 16 consecutive patients diagnosed with sDAVF was reviewed. Pre- and post-operative neurological condition was evaluated using both the Aminoff and Logue disability scale and the VAS scale. Rates of complete occlusions, technical difficulties, and procedural complications were noted.
Results. Four of the patients were female and 12 were male; mean age was 62.4 years. Mean interval between symptom onset and treatment was 13.3 months. Complete occlusion was achieved in 88% (14/16 patients). Significant or moderate clinical improvement in long-term follow-up was observed in eight patients (50%). Recurrence was observed in two cases (13%).
Conclusions and clinical implications. While endovascular methods are being refined and thus achieving an increasing
percentage of successful occlusions, patients should be closely monitored since this condition is recurrent and the clinical
consequences of myelopathy can persist despite complete occlusion of the shunt.
Abstract
Aim of study. Spinal dural arteriovenous fistulas (sDAVF) are rare spinal cord lesions formed between a radicular artery and medullary vein leading to venous hypertension resulting in neurological impairment. Endovascular embolisation is a minimally-invasive method aiming to interrupt the shunt between the artery and vein. We report our experience with sDAVF treated endovascularly.
Material and methods. Clinical and procedural data of 16 consecutive patients diagnosed with sDAVF was reviewed. Pre- and post-operative neurological condition was evaluated using both the Aminoff and Logue disability scale and the VAS scale. Rates of complete occlusions, technical difficulties, and procedural complications were noted.
Results. Four of the patients were female and 12 were male; mean age was 62.4 years. Mean interval between symptom onset and treatment was 13.3 months. Complete occlusion was achieved in 88% (14/16 patients). Significant or moderate clinical improvement in long-term follow-up was observed in eight patients (50%). Recurrence was observed in two cases (13%).
Conclusions and clinical implications. While endovascular methods are being refined and thus achieving an increasing
percentage of successful occlusions, patients should be closely monitored since this condition is recurrent and the clinical
consequences of myelopathy can persist despite complete occlusion of the shunt.
Keywords
spinal dural arteriovenous fistulas, endovascular, embolisation, outcome
About this articleTitle
Endovascular embolisation as minimally-invasive treatment for spinal dural arteriovenous fistulas — evaluation of long-term results
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Short Communication
Pages
305-309
Published online
2023-04-28
Page views
1369
Article views/downloads
345
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2023;57(3):305-309.
Keywords
spinal dural arteriovenous fistulas
endovascular
embolisation
outcome
Authors
Paweł Szmygin
Maciej Szmygin
Tomasz Roman
Tomasz Jargiełło
Radosław Rola
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