| [PMID]: | 28106525 |
| [Au] Autor: | Koch MJ; Stapleton CJ; Agarwalla PK; Torok C; Shin JH; Coumans JV; Borges LF; Ogilvy CS; Rabinov JD; Patel AB |
| [Ad] Endereço: | Departments of 1 Neurosurgery and. |
| [Ti] Título: | Open and endovascular treatment of spinal dural arteriovenous fistulas: a 10-year experience. |
| [So] Source: | J Neurosurg Spine;26(4):519-523, 2017 Apr. |
| [Is] ISSN: | 1547-5646 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | OBJECTIVE Vascular malformations of the spine represent rare clinical entities with profound neurological implications. Previously reported studies on management strategies for spinal dural arteriovenous fistulas (sDAVFs) appeared before the advent of modern liquid embolic agents. Authors of the present study review their institutional experience with endovascularly and surgically treated sDAVFs. METHODS The authors performed a retrospective, observational, single-center case series on sDAVFs treated with endovascular embolization, microsurgical occlusion, or both between 2004 and 2013. The mode, efficacy, and clinical effect of treatment were evaluated. RESULTS Forty-seven patients with spinal arteriovenous malformations were evaluated using spinal angiography, which demonstrated 34 Type I sDAVFs (thoracic 20, lumbar 12, and cervical 2). Twenty-nine of the patients (85%) were male, and the median patient age was 63.3 years. Twenty patients underwent primary endovascular embolization (16 Onyx, 4 N-butyl cyanoacrylate [NBCA]), and 14 underwent primary surgical clipping. At a mean follow-up of 36 weeks, according to angiography or MR angiography, 5 patients treated with endovascular embolization demonstrated persistent arteriovenous shunting, whereas none of the surgically treated patients showed lesion persistence (p = 0.0237). Thirty patients (88%) experienced some resolution of their presenting symptoms (embolization 17 [85%], surgery 13 [93%], p = 1.00). CONCLUSIONS Microsurgical occlusion remains the most definitive treatment modality for sDAVFs, though modern endovascular techniques remain a viable option for the initial treatment of anatomically amenable lesions. Treatment of these lesions usually results in some clinical improvement. |
| [Mh] Termos MeSH primário: |
Malformações Vasculares do Sistema Nervoso Central/terapia
Embolização Terapêutica
Procedimentos Endovasculares
Microcirurgia
Procedimentos Neurocirúrgicos
Doenças Vasculares da Medula Espinal/terapia
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| [Mh] Termos MeSH secundário: |
Angiografia
Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem
Embolização Terapêutica/efeitos adversos
Embolização Terapêutica/métodos
Procedimentos Endovasculares/efeitos adversos
Procedimentos Endovasculares/métodos
Feminino
Seguimentos
Seres Humanos
Masculino
Microcirurgia/efeitos adversos
Microcirurgia/métodos
Meia-Idade
Procedimentos Neurocirúrgicos/efeitos adversos
Procedimentos Neurocirúrgicos/métodos
Complicações Pós-Operatórias
Doenças Vasculares da Medula Espinal/diagnóstico por imagem
Resultado do Tratamento
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE; OBSERVATIONAL STUDY |
| [Em] Mês de entrada: | 1704 |
| [Cu] Atualização por classe: | 171116 |
[Lr] Data última revisão:
| 171116 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 170121 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.3171/2016.9.SPINE16394 |
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