A case of filum terminale arterial venous fistula needed a long arterial access for trans-arterial shunt obliteration

Abstract

<jats:p> A 78-year-old man was referred to our institution with a predominantly progressive numbness of both legs, and bladder dysfunction with urinary retention. He was diagnosed as the symptomatic arteriovenous fistula of the filum terminale (AVFFT). A trans-arterial embolization (TAE) of the arteriovenous shunt was planned for his symptomatic AVFFT. The long distance between the origin of the radiculo meningeal artery (Th8) and the site of the fistula (S1) resulted in the first TAE having a feeder occlusion. The length of accessible feeder in the first TAE was the longest (about 40 cm) as the past reports of the endovascular therapy. However, complete shunt occlusion was accomplished at a second session two weeks after the initial TAE because a more accessible feeder was developed by the initial feeder occlusion. </jats:p>

Filum terminale arteriovenous fistula with additional arterial supply by the posterior spinal artery: A report of two cases

“…In addition, endovascular has a chance of recanalization or recurrence of the fistula more than surgery. [ 2 3 5 18 ] In the present study, we decided to try endovascular treatment as first choice in the first case because there was the accessible dilated PSA connecting with the artery of the filum, the termination of the ASA, through the arterial basket of the conus medullaris. The important factor for the successful transarterial embolization is an introduction of the tip of microcatheter in a more stable and distal position to the shunt point.…”

Arteriovenous fistula of the filum terminale masqueraded as a failed back surgery syndrome – A case report and review of literature

“…[ 2 , 6 , 9 , 22 ] These are generally characterized by a single direct shunt between the artery of the filum terminale (distal prolongation of ASA) and a draining vein. [ 1 , 3 , 6 , 8 , 9 , 12 , 18 , 29 , 33 ] Rarely, these FTAVF can have multiple shunt points. [ 6 , 8 , 9 ] Because of its different morphology and the unique location along the filum terminale, some authors advocate that FTAVF should be classified as a distinct form of intradural arteriovenous shunt.…”

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

“…2,8,11 FTAVFs with additional supply from the sacral level have been reported. [7][8][9]11 Although the blood supply of the FTE is not wellcharacterized, straight blood vessels following the FTE course have been identified in some cases. 4 However, the origin of this vessel and detailed angioarchitecture of the FTE remain unclear.…”

“…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.…”