[Use of different endovascular treatments for arteriovenous malformations of the spinal cord]

The paper presents outcomes of treatment of patients with arteriovenous malformations (AVM) of the spinal cord by using endovascular techniques in 171 patients. There were a total of 364 occluded afferent vessels involved in the blood supply to and development of AVM. A classification of spinal cord AVM is presented. Methods for occlusion were described in relation to the type AVM. Malformations were thrombosed with polyvinyl acetate (PVA) emboli in 129 patients; balloon occlusion of afferent vessels was performed in 6, as described by F. A. Serbinenko; histoacryl glue was applied in 27 cases. A combined method of occlusion of afferent vessels was used with PVA emboli and balloons in 9 patients. The clinical picture of spinal cord AVM was outlined. Emphasis is laid on diagnostic methods, such as selective angiography and magnetic resonance imaging, as well as on their role in postoperative control studies, in determining the degree of thrombosis, the presence of ischemic events, and subarachnoidal space patency. Endovascular treatment used in patients with AVM at different levels of the spinal cord alleviated neurological symptoms in 155 (91%) patients. There was no improvement in 12 (7%) patients. Complications at angiography and embolization were observed with deteriorated neurological symptoms in 4 (2%) cases. Further development and improvement of endovascular treatments in patients with spinal cord will be promising if new intervention technologies are introduced in clinical practice.