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Published on: March 4, 2016
[Endovascular treatment of spinal dorsal intradural arteriovenous fistulas]
Jorge Arturo Santos-Franco1, María Griselda Lizbeth Collado-Arce, Julio César Dávila-Romero
1Servicio de Neurocirugía, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Distrito Federal, México. jasantosfranco@hotmail.com.
Background:
The dorsal spinal intradural arteriovenous fistulas (DSIAF) are infrequent and complex injuries are underdiagnosed condition and disability. The aim is to present our experience in the endovascular management.
Methods:
A retrospective and prospective study of patients with DSIAF treated by endovascular therapy (EVT) with n-butyl-cyanoacrylate during the period 2007-2013.
Results:
15 patients, 12 men and 3 women, mean age 37 years, were included. In 12 cases, the presentation was progressive and insidious over a period between 6 months and one year, while 3 had bleeding. The lesion in the thoracic location had 73 % of cases, lumbar 20 % and cervical 7 %. Prior to treatment observed disability grades 5 and 4 in 73 %, and 67 % had micturition disturbances. Complications grade 3, only one patient had transient deterioration of alert 6 hours after the procedure. Improvement to grades 1 and 2 disability at 48 hours, 3 and 6 months, 53 %, 73 % and 87 % respectively was found.
Conclusion:
EVT has a short operating time, bleeding volume is very low and the hospital stay is short compared with other surgical techniques. EVT is a safe and significant effectiveness in treating DSIAF procedure. This is the first series of cases treated with EVT in Mexico.
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