Radiculo-pial spinal arteriovenous fistulas treated with coils: Report of two cases

Abstract

<jats:p> Spinal pial arteriovenous fistulas (SPAVFs) are rare lesions that present more frequently in young patients. Lesions located on radiculo-pial arteries without involvement of the anterior spinal artery are even rarer. SPAVFs may present with mass effect, venous congestion or hemorrhage. Most often, treatment is performed either by surgery or endovascularly with fluid embolic material. Use of microcoils has not been reported for this condition. </jats:p><jats:p> We present two cases of radiculo-pial high-flow SPAVFs in two patients in their early 30 s. One patient presented with abrupt headache without proof of hemorrhage and the other one with trigeminal neuralgia resulting from dilated posterior fossa draining veins remote from the fistula. Both patients were successfully treated with endovascular shunt closure using microcoils with resolution of symptoms and disappearance of the dilated veins at follow-up. </jats:p><jats:p> With recent advances in microcatheter technology, distal navigation and microcoil embolization offers another option for these cases that may be safer than fluid embolic material. </jats:p>

Study and therapeutic progress on spinal cord perimedullary arteriovenous fistulas

“…Pasqualetto et al used a coil to treat a boy with a type C high-flow PMAVF, and a good outcome was achieved (70). In addition, Batista et al used coils to embolize two high-flow PMAVFs that were fed by the posterior spinal artery and good outcomes were achieved (71). Therefore, the use of a coil may offer a safe and effective strategy in some high-flow PMAVFs.…”