Endovascular Management of Spinal Dural Arteriovenous Fistulas

Abstract

Spinal vascular malformations, although rare, cause devastating disease. These malformations are commonly categorized as follows: spinal arteriovenous malformations (AVMs), dural arteriovenous fistulas (DAVFs), spinal hemangiomas, cavernous angiomas, and aneurysms. Spinal DAVFs (SDAVFs), or type 1 spinal AVMs, occur most frequently, representing ? 60 to 80% of vascular malformations of the spinal cord. While previously microsurgical treatment was considered the gold standard in the treatment of SDAVFs, recent advancements in technology?advancements of magnetic resonance imaging as a screening examination, contrast-enhanced magnetic resonance angiography, multidetector computed tomography as preangiographic evaluations, digital subtraction angiography, diagnostic catheters, and embolization materials?have made endovascular treatment a possible option. We review the treatment of SDAVFs, primarily discussing the endovascular management of these lesions.

Spinal dural and epidural arteriovenous fistula: Recurrence rate after surgical and endovascular treatment

“…Surgical treatment has been shown to ensure more effective resolution of the fistula. Endovascular treatment, while not guaranteeing the same success rate, should be considered a less invasive technique which should be offered to selected patients with contra-indications for surgery ( 21 ). Regarding the 5 patients with EAVFs, a recurrence occurred in 20% of the surgical treatments and in 80% of the endovascular treatments.…”