Vascular orientation by intra-arterial dye injection during spinal arteriovenous malformation surgery.
OBJECTIVE
Rich and complicated vascular structures on the spinal cord often interfere with obliteration of a spinal arteriovenous malformation (AVM). Vascular orientation during spinal AVM surgery is essential. The authors recently performed six consecutive spinal AVM surgeries in five patients (two with perimedullary AVMs, and three with dural arteriovenous fistulae) with the aid of intra-arterial injection of dye (indigo carmine).


METHODS
Two representative cases are described. A microcatheter was placed preoperatively in the artery of interest. Subsequent to the exposure of the vascular complex, a 1-ml injection of indigo carmine (2 mg/ml) clearly demonstrated the feeding arteries and the draining veins around the AVM or dural arteriovenous fistula.


RESULTS
One patient had repeat surgery because of incomplete obliteration of the AVM owing to migration of the catheter. All patients, except one who had temporary postoperative deterioration and persistent neurological deficits, had good surgical outcomes, however. No apparent side effects caused by the dye were reported.


CONCLUSIONS
The assistance system for spinal AVM surgery is easy and safe and can be applied in other surgical institutions.
Tani
S
S
Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan. tani@jikei.ac.jp
Ikeuchi
S
S
Hata
Y
Y
Abe
T
T
D000792:Angiography; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D004396:Coloring Agents / Q000008:administration & dosage; D006801:Humans; D007203:Indigo Carmine / Q000008:administration & dosage; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging; D016896:Treatment Outcome
D004396:Coloring Agents; D007203:Indigo Carmine