[Silicone pellet embolization of spinal cord arteriovenous malformation--case report (author's transl)]

This is a report of case with the spinal cord arteriovenous malformation in which silicone pellet embolizations of the feeding arteries were carried out through a percutaneous catheter. The technical details are presented. (Case report) A 35-year-old paraplegic patient. Her radiograms are shown Figs. 1 to 5. An attempt to direct removal of the AVM was limited to the laminectomy (Th1--4) because of extensive haemorrhage in the extradural space. Small silicon pellets with barium sulfate were used to occlude the feeder in this case. The large AVM at the high thoracic level was supplied by feeders coming from the branches of thyreocervical trunk in both side. In the right, six pellets of a proper size were used. Angiogram taken immediately after injection of emboli, demonstrated a decrease of volume of the AVM to about a half (Fig. 2-b), and six months later, the spinal feeders had been embolized almost completely (Fig. 5-a). In the left side, two pellets were injected through the left thyreocervical trunk but the malformation was depicted at the follow-up angiogram taken about six months later. She went to the rehabilitation clinic after surgery and her palaplegia improved remarkably. At present, she can walk on crutches. Disturbances to evacuation and urination have also disappeared.