title: Endovascular treatment in spinal perimedullary arteriovenous fistula.
abstract: This study includes 20 patients with 21 spinal perimedullary fistulae. There were nine Type IVa (42.8%) lesions, ten Type IVb (47.6%) and two Type IVc (9.5%) lesions. The dominant arterial supply was from the anterior spinal artery (47.6%), posterior spinal artery (19%) and directly from the radiculomedullary artery (28.5%). Sixteen lesions in 15 patients were treated by endovascular route using n-butyl-2-cyanoacrylate. Endovascular treatment was not feasible in five patients. Of the ten patients with microfistulae, catheterization failed/was not attempted in 40%, complete obliteration of the lesion was seen in 60% but clinical improvement was seen in 40% of patients. Catheterization was feasible in all ten patients with macrofistulae (nine type IVb and two type IVc lesions). Complete obliteration of the lesions was seen in 60% and residue in 30%. Clinical improvement was seen in 80% and clinical deterioration in 10%. In conclusion, endovascular glue embolization is safe and efficacious in type IVb and IVc spinal perimedullary fistulae and should be considered the first option of treatment. It is also feasible in many of the type IVa lesions.
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow, Uttar Pradesh, India - rphadke@sgpgi.ac.in.
authors: Rajendra V
authors: RV
authors: Phadke
authors: Institute of Postgraduate Medical Education & Research; Kolkata, India.
authors: Avik
authors: A
authors: Bhattacharyya
authors: North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences; Shillong, Meghalaya, India.
authors: Akash
authors: A
authors: Handique
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow, Uttar Pradesh, India.
authors: Krishan
authors: K
authors: Jain
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow, Uttar Pradesh, India.
authors: Alok
authors: A
authors: Kumar
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow, Uttar Pradesh, India.
authors: Vivek
authors: V
authors: Singh
authors: Assam Medical College and Hospital; Dibrugarh, Assam, India.
authors: Deb
authors: D
authors: Baruah
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow, Uttar Pradesh, India.
authors: Tushant
authors: T
authors: Kumar
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow, Uttar Pradesh, India.
authors: Sriram
authors: S
authors: Patwari
authors: Sanjay Gandhi Postgraduate Institute of Medical Sciences; Lucknow, Uttar Pradesh, India.
authors: B Madan
authors: BM
authors: Mohan
mesh_terms: D000293:Adolescent; D000328:Adult; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D005296:Ferrous Compounds / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging; D055815:Young Adult
chemical_list: D005296:Ferrous Compounds; C014580:hemostimulin; D004659:Enbucrilate
keywords: embolization; perimedullary arteriovenous fistula; spinal cord