Comparison of 3 Different Types of Spinal Arteriovenous Shunts below the Conus in Clinical Presentation, Radiologic Findings, and Outcomes

Abstract

BACKGROUND AND PURPOSE:Spinal arteriovenous shunts below the conus constitute 3 types of lesions, which have previously been mainly described in case reports, given their rarity, and are sometimes misdiagnosed. The purpose of this study was to describe the features of each type and compare these types as to epidemiologic features, clinical and radiologic presentations, treatment, and outcomes in a consecutive series of 48 cases.

Concomitant conus medullaris arteriovenous shunts and sacral dural arteriovenous fistulas: pathophysiological links related to the venous drainage of the lesions in a series of five cases

“…In these cases the link between the two types of lesions seems definitely metameric for embryological reasons. Although the differential diagnosis between radicular AVS and sDAVF can be difficult, they are different and well-defined pathological entities 7. In our series, 13 cases were found of scAVMs with associated radicular AVMs.…”

Transradial approach in the treatment of a sacral dural arteriovenous fistula: a technical note

“…Similar to their more common thoracic counterparts, SDAVFs can lead to devastating venous hypertensive myelopathy. Diagnosis is made through a complete spinal angiography including a pelvic aortogram and selective injections of the median sacral artery and bilateral external and internal iliac arteries, as these malformations most often arise from the LSA 2 3. Treatment requires positioning of a guiding catheter in the IIA and navigation of a microcatheter as close to the fistula as possible to deliver the embolic agent.…”

“…Sacral dural arteriovenous fistulas (SDAVFs) are rare, constituting approximately 10% of spinal fistulas 1. Most often, they arise from dural arterial feeders from the lateral sacral artery (LSA) 2. If embolization is deemed appropriate, selective cannulation of the internal iliac artery (IIA) with a guiding catheter is necessary in order to reach the fistulous point with a microcatheter.…”

Spinal arteriovenous fistula located in the filum terminale externa: A case report and review of the literature

“…3,6 Most reported FTAVFs are intradural spinal AVFs that developed in the FTI and present with perimedullary drainage. 3,[5][6][7][8][9] The FTAVF angioarchitecture is typically simple and comprises focal or single hole fistulas located below the conus medullaris supplied by the artery of the FT (AFT) with perimedullary venous drainage through the vein of the FT (VFT). 3,6,10 However, the FTE has not received much attention because it is an extradural component of the FT.…”