Spinal Vascular Malformations: MR Angiography after Treatment

Mascalchi, Mario; Ferrito, G.; Quilici, N.; Mangiafico, Salvatore; Cosottini, Mirco; Cellerini, M.; Politi, Letterio S.; Guerrini, Laura; Bartolozzi, Carlo; Villari, Natale

doi:10.1148/radiology.219.2.r01ap26346

Cited by 61 publications

(31 citation statements)

References 20 publications

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“…The treatment results were confirmed by angiography or, for highrisk patients, by MRI, as indicated by Mascalchi et al, 11 preferably during the same hospital admission as the treatment. Clinical follow-up was obtained in a multidisciplinary clinic attended by both interventional neuroradiologists and neurosurgeons.…”

Section: Follow-upmentioning

confidence: 80%

Multidisciplinary Management of Spinal Dural Arteriovenous Fistulas

Dijk

terBrugge

Willinsky

et al. 2002

Stroke

244

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Section: Follow-upmentioning

confidence: 80%

Multidisciplinary Management of Spinal Dural Arteriovenous Fistulas

Dijk

terBrugge

Willinsky

et al. 2002

Stroke

244

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“…If complete shunt occlusion is achieved, oxygen saturation is expected to return to normal, as was demonstrated in our study population. If the treatment tive modalities to evaluate spinal AVMs (15)(16)(17)(18)(19). These techniques are less invasive than conventional DSA; however, they are also less sensitive to depict abnormal vessels than conventional DSA and sometimes fail to specify the exact shunt point ( 16,20 ).…”

Section: Neuroradiology: Susceptibility-weighted Mr Imaging Of Oxygenmentioning

confidence: 99%

Spinal Arteriovenous Malformation: Evaluation of Change in Venous Oxygenation with Susceptibility-weighted MR Imaging after Treatment

Fujima¹,

Kudo²,

Terae³

et al. 2010

Radiology

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“…11 Magnetic resonance angiography has also been reported as a sensitive technique in the assessment of residual blood flow following treatment for spinal DAVFs. 41 Standard catheter angiography remains the gold standard in the diagnosis of spinal DAVFs. When attempting to locate a feeder vessel to a suspected AVF, the intercostal, lumbar, sacral, deep cervical, and ascending cervical arteries should all be visualized.…”

Section: Diagnosismentioning

confidence: 99%

Endovascular management of spinal dural arteriovenous fistulas

Sivakumar

Zada²,

Yashar³

et al. 2009

FOC

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Object Spinal dural arteriovenous fistulas (DAVFs) are the most common spinal vascular malformations and can be a significant cause of myelopathy, yet remain inefficiently diagnosed lesions. Over the last several decades, the treatment of spinal DAVFs has improved tremendously due to improvements in neuroimaging, microsurgical, and endovascular techniques. The aim of this paper was to review the existing literature regarding the clinical characteristics, classification, and endovascular management of spinal DAVFs. Methods A search of the PubMed database from the National Library of Medicine and reference lists of all relevant articles was conducted to identify all studies pertaining to spinal DAVFs, spinal dural fistulas, and spinal vascular malformations, with particular attention to endovascular management and outcomes. Results The ability to definitively treat spinal DAVFs using endovascular embolization has significantly improved over the last several decades. Overall rates of definitive embolization of spinal DAVFs have ranged between 25 and 100%, depending in part on the embolic agent used and the use of variable stiffness microcatheters. The majority of recent studies in which N-butyl cyanoacrylate or other liquid embolic agents were used have reported success rates of 70–90%. Surgical treatment remains the definitive option in cases of failed embolization, repeated recanalization, or lesions not amenable to embolization. Clinical outcomes have been comparable to surgical treatment when the fistula and draining vein remain persistently occluded. Improvements in gait and motor function are more likely following successful treatment, whereas micturition symptoms are less likely to improve. Conclusions Endovascular embolization is an increasingly effective therapy in the treatment of spinal DAVFs, and can be used as a definitive intervention in the majority of patients that undergo modern endovascular intervention. A multidisciplinary approach to the treatment of these lesions is required, as surgery is required for refractory cases or those not amenable to embolization. Newer embolic agents, such as Onyx, hold significant promise for future therapy, yet long-term follow-up studies are required.

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Spinal Vascular Malformations: MR Angiography after Treatment

Abstract: MR angiography is more sensitive than MR imaging in depicting residual or recurrent flow in peri- or intramedullary vessels, which indicates patency of the vascular malformation.

Cited by 61 publications

References 20 publications

Multidisciplinary Management of Spinal Dural Arteriovenous Fistulas

Multidisciplinary Management of Spinal Dural Arteriovenous Fistulas

Spinal Arteriovenous Malformation: Evaluation of Change in Venous Oxygenation with Susceptibility-weighted MR Imaging after Treatment

Endovascular management of spinal dural arteriovenous fistulas

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