The clinical signs, diagnostics and endovascular treatment of dural arteriovenous fistulas of spinal cord
https://doi.org/10.17650/1683-3295-2016-0-2-9-15
Abstract
Objective: to summarize the author’s own experience in treatment of patients suffered from spinal dural arteriovenous fistulas (DAVF). Material and methods. The analysis of endovascular treatment outcomes of 160 spinal DAVFs was performed. Men were 83%, women - 17%, average age - 52 years old. The clinical signs of progressive myelopathy were lower paraparesis of various severity degree (10% of cases - lower paraplegia), sensitive and pelvic disturbances. DAVFs were verified by data of MRI and spinal angiography. The glue compositions consisting of hystoacril or N-butil-cyanoacrylate mixed with lipiodol as well as polyvinyl acetate emboli (PVA) sized from 100 till 500 micron were used for occlusion of afferent vessels of DAVFs in the areas of pathological veins. Results. Endovascular treatment of spinal DAVFs allowed stabilizing or decreasing the severity of neurological signs in 90% of clinical cases. The improving of clinical outcomes in case of earlier embolization of DAVFs was detected. The usage of steroids as antiedemic therapy resulted in deterioration of neurological clinical signs (lower paraparesis, pelvic disturbances) and worsened the outcomes. Conclusion: endovascular embolization of spinal DAVFs is effective treatment method.
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Review
For citations:
Tissen T.P. The clinical signs, diagnostics and endovascular treatment of dural arteriovenous fistulas of spinal cord. Russian journal of neurosurgery. 2016;(2):9-15. (In Russ.) https://doi.org/10.17650/1683-3295-2016-0-2-9-15
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