Endovascular management of aneurysms associated with spinal arteriovenous malformations

Jung, Sung Chul; Song, Yunsun; Cho, Su Hee; Kim, Joong-Goo; Noh, Seung Yeon; Lee, Sang Hun; Sheen, Jae Jon; Rhim, Seung Chul; Jeon, Sang Ryong; Suh, Dae Chul

doi:10.1136/neurintsurg-2017-013150

Cited by 18 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3] Our study also demonstrated an excellent occlusion rate (100%) and good treatment outcomes (91%). Intradural venous drainage, noted in 53.8% 7 of the 13 patients in this study, was seen with variable frequency in previous studies (27.0% 2 to 74.5% 4 ). In this study, ALS scores were zero in all patients without intradural venous drainage except for 1 patient who had mild leg weakness caused by compressive myelopathy.…”

Section: Discussionsupporting

confidence: 45%

“…5 Differentiation from other spinal vascular pathology, including SDAVF, is mandatory to localize the exact cause of presenting symptoms. 6,7 SEDAVFs can be categorized into 2 distinct presenting symptom patterns, depending on the involvement of the intradural vein. 8 With intradural venous reflux, they may mimic SDAVFs with symptoms of congestive myelopathy such as lower leg weakness and sphincter dysfunction.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Osseous versus Nonosseous Spinal Epidural Arteriovenous Fistulas: Experiences of 13 Patients

Song

Cho

Lee

et al. 2018

AJNR Am J Neuroradiol

Self Cite

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE: Spinal epidural arteriovenous fistulas are rare vascular malformations. We present 13 patients with spinal epidural arteriovenous fistulas, noting the various presenting symptom patterns, imaging findings related to bone involvement, and outcomes. MATERIALS AND METHODS:Among 111 patients with spinal vascular malformations in the institutional data base from 1993 to 2017, thirteen patients (11.7%) had spinal epidural arteriovenous fistulas. We evaluated presenting symptoms and imaging findings, including bone involvement and mode of treatment. To assess the treatment outcome, we compared initial and follow-up clinical status using the modified Aminoff and Logue Scale of Disability and the modified Rankin Scale. RESULTS:The presenting symptoms were lower back pain (n ϭ 2), radiculopathy (n ϭ 5), and myelopathy (n ϭ 7). There is overlap of symptoms in 1 patient (No. 11). Distribution of spinal epidural arteriovenous fistulas was cervical (n ϭ 3), thoracic (n ϭ 2), lumbar (n ϭ 6), and sacral (n ϭ 2). Intradural venous reflux was identified in 7 patients with congestive venous myelopathy. The fistulas were successfully treated in all patients who underwent treatment (endovascular embolization, n ϭ 10; operation, n ϭ 1) except 2 patients who refused treatment due to tolerable symptoms. Transarterial glue (n ϭ 7) was used in nonosseous types; and transvenous coils (n ϭ 3), in osseous type. After 19 months of median follow-up, the patients showed symptom improvement after treatment. CONCLUSIONS:Although presenting symptoms were diverse, myelopathy caused by intradural venous reflux was the main target of treatment. Endovascular treatment was considered via an arterial approach in nonosseous types and via a venous approach in osseous types.ABBREVIATIONS: ALS ϭ Aminoff and Logue Scale of Disability; SDAVF ϭ spinal dural arteriovenous fistula; SEDAVF ϭ spinal epidural arteriovenous fistula; TAE ϭ transarterial embolization; TVE ϭ transvenous embolization

show abstract

Section: Discussionsupporting

confidence: 45%

mentioning

confidence: 99%

Osseous versus Nonosseous Spinal Epidural Arteriovenous Fistulas: Experiences of 13 Patients

Song

Cho

Lee

et al. 2018

AJNR Am J Neuroradiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Aneurysms on the arterial feeders of the AVMs are known to be associated with an increased risk of rebleeding 21. They are usually considered as a target of embolization with cyanoacrylate or surgery 22. We reported in our series five patients with such aneurysms which were definitely occluded using particle embolization (figure 1).…”

Section: Discussionmentioning

confidence: 69%

Long term follow-up of endovascular management of spinal cord arteriovenous malformations with emphasis on particle embolization

Collin

Labeyrie²,

Lenck

et al. 2018

J NeuroIntervent Surg

View full text Add to dashboard Cite

Our study suggests that particle embolization as a firstline therapy to treat spinal cord AVMs is safe and offers long term efficacy, especially for those with small, distal, and multiple shunts. Partial occlusion of the AVM may be sufficient to prevent rebleeding, without the potential risks of complete occlusion. Particle calibration and injection technique, 'one by one', are critical to safety. Cyanoacrylate embolization or surgery remains necessary if particle embolization fails to occlude large shunts.

show abstract

“…ASA aneurysms are rare and are mainly located in the upper cervical segment (4,(79)(80)(81)(82). They are typically dissections and can be divided into isolated and flow-related types (83,84).…”

Section: Cervical Asa Aneurysmmentioning

confidence: 99%

Role of the Cervical Anterior Spinal Artery in the Endovascular Treatment of Vascular Diseases: Bystander, Accomplice, Victim, or Friend?

Zhang

Hou

et al. 2021

Front. Neurol.

View full text Add to dashboard Cite

The cervical anterior spinal artery (ASA) is a very important artery arising from the intracranial vertebral artery (VA). It can play different roles in endovascular treatment (EVT) of spinal vascular diseases. The current understanding of these roles is incomplete; therefore, we performed this review. We found that cervical ASA can be involved in many spinal vascular diseases, such as arteriovenous fistula (AVF), arteriovenous malformation (AVM), and aneurysm, and can serve as a collateral channel in proximal VA occlusion. In AVF and AVM, when the cervical ASA is involved, it often plays the role of an accomplice or victim because it acts as the feeder or as a bystander that does not provide blood flow to the AVF and AVM. In cervical ASA aneurysm, the ASA is a victim. During EVT of VA aneurysms or stenoses, the cervical ASA ostia can be covered or occluded, resulting in ASA ischemia. In this situation, the ASA is a victim. In VA occlusion or the subclavian steal phenomenon, the cervical ASA can serve as a collateral channel to provide blood flow to the posterior circulation. In this case, the ASA plays the role of a friend. According to the role of the cervical ASA in spinal vascular diseases, EVT should be determined “case by case.” Most importantly, when EVT is performed to treat these diseases, the cervical ASA axis must be preserved. Therefore, understanding the role of the cervical ASA in spinal vascular diseases is crucial.

show abstract

Endovascular management of aneurysms associated with spinal arteriovenous malformations

Abstract: Identification of a symptomatic aneurysm should be associated with clinical presentation pattern. Targeted obliteration of the aneurysm by embolization and/or surgery resulted in improvement of symptoms and stabilization of SAVM.

Cited by 18 publications

References 19 publications

Osseous versus Nonosseous Spinal Epidural Arteriovenous Fistulas: Experiences of 13 Patients

Osseous versus Nonosseous Spinal Epidural Arteriovenous Fistulas: Experiences of 13 Patients

Long term follow-up of endovascular management of spinal cord arteriovenous malformations with emphasis on particle embolization

Role of the Cervical Anterior Spinal Artery in the Endovascular Treatment of Vascular Diseases: Bystander, Accomplice, Victim, or Friend?

Contact Info

Product

Resources

About