title: Rotational angiography for diagnosis and surgical planning in the management of spinal vascular lesions.
abstract: OBJECTIVE
  The management of spinal vascular malformations has undergone significant evolution with the advent of advanced endovascular and angiographic technology. Three-dimensional rotational spinal angiography is an advanced tool that allows the surgeon to gain a better appreciation of the anatomy of these spinal vascular lesions and their relation to surrounding structures. This article describes the use of rotational angiography and 3D reconstructions in the diagnosis and management of spinal vascular malformations.
  
  
  METHODS
  The authors present representative cases involving surgical treatment planning for spinal vascular malformations with focus on the utility and technique of rotational spinal angiography. They report the use of rotational spinal angiography for a heterogeneous collection of vascular pathological conditions.
  
  
  RESULTS
  Eight patients underwent rotational spinal angiography in addition to digital subtraction angiography (DSA) for the diagnosis and characterization of various spinal vascular lesions. Postprocessed images were used to characterize the lesion in relation to surrounding bone and to enhance the surgeon's ability to precisely localize and obliterate the abnormality. The reconstructions provided superior anatomical detail compared with traditional DSA. No associated complications from the rotational angiography were noted, and there was no statistically significant difference in the amount of radiation exposure to patients undergoing rotational angiography relative to traditional angiography.
  
  
  CONCLUSIONS
  The use of rotational spinal angiography provides a rapid and powerful diagnostic tool, superior to conventional DSA in the diagnosis and preoperative planning of a variety of spinal vascular pathology. A more detailed understanding of the anatomy of such lesions provided by this technique may improve the safety of the surgical approach.
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA.
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Ropper
authors.forename: Ning
authors.initials: N
authors.lastname: Lin
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Gross
authors.forename: Hekmat K
authors.initials: HK
authors.lastname: Zarzour
authors.forename: Ruth
authors.initials: R
authors.lastname: Thiex
authors.forename: John H
authors.initials: JH
authors.lastname: Chi
authors.forename: Rose
authors.initials: R
authors.lastname: Du
authors.forename: Kai U
authors.initials: KU
authors.lastname: Frerichs
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020758:Spinal Cord Vascular Diseases / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult