title: A case of filum terminale arterial venous fistula needed a long arterial access for trans-arterial shunt obliteration.
abstract: A 78-year-old man was referred to our institution with a predominantly progressive numbness of both legs, and bladder dysfunction with urinary retention. He was diagnosed as the symptomatic arteriovenous fistula of the filum terminale (AVFFT). A trans-arterial embolization (TAE) of the arteriovenous shunt was planned for his symptomatic AVFFT. The long distance between the origin of the radiculo meningeal artery (Th8) and the site of the fistula (S1) resulted in the first TAE having a feeder occlusion. The length of accessible feeder in the first TAE was the longest (about 40 cm) as the past reports of the endovascular therapy. However, complete shunt occlusion was accomplished at a second session two weeks after the initial TAE because a more accessible feeder was developed by the initial feeder occlusion.
authors.affiliation: 1 Department of Neurosurgery, Nara Medical University, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Wajima
authors.affiliation: 1 Department of Neurosurgery, Nara Medical University, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakagawa
authors.affiliation: 1 Department of Neurosurgery, Nara Medical University, Japan.
authors.forename: Hun-Soo
authors.initials: HS
authors.lastname: Park
authors.affiliation: 1 Department of Neurosurgery, Nara Medical University, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Haku
authors.affiliation: 2 Department of Radiology, Nara Medical University, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wada
authors.affiliation: 2 Department of Radiology, Nara Medical University, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
authors.affiliation: 1 Department of Neurosurgery, Nara Medical University, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakase
mesh_terms: D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D002420:Cauda Equina; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male
keywords: Accessible feeder; arteriovenous fistula of the filum terminale; trans-arterial embolization