Spinal dural and epidural arteriovenous fistula: Recurrence rate after surgical and endovascular treatment.
endovascular treatment
epidural fistula
spinal AVMs
spinal fistula
spinal neurosurgery
Journal
Frontiers in surgery
ISSN: 2296-875X
Titre abrégé: Front Surg
Pays: Switzerland
ID NLM: 101645127
Informations de publication
Date de publication:
2023
2023
Historique:
received:
20
01
2023
accepted:
21
03
2023
medline:
21
4
2023
pubmed:
21
4
2023
entrez:
21
04
2023
Statut:
epublish
Résumé
Spinal dural arteriovenous fistula consist of an heterogenous group of vascular malformation often causing severe neurological deficit due to progressive myelopathy. This type of malformation could be associated with subarachnoid or subdural hemorrhage inside the spinal canal. In the English literature surgical treatment is regarded as the best option if compared to endovascular procedure, being the latter associated with an increased risk of relapse despite its less invasiveness. In this study a retrospective analysis of 30 patients with spinal dural and epidural fistula associated with perimedullary venous congestion was undertaken. The radiological and clinical presentation of each patient is analyzed, and the grade of myelopathy is classified through the mJOA score. A total number of 31 out of 41 collected procedures (22 surgery vs. 19 endovascular) were dural fistulas while the remaining 10 were classified as epidural. A 46% recurrence rate for endovascular treatment against 0% for surgical ( According to the results, surgical treatment could be considered as first-line treatment for spinal dural arteriovenous fistulas. Endovascular embolization can be proposed in selected cases, as a less invasive technique, for elderly patients or with important comorbidities. In spinal epidural arteriovenous fistulas, in view of the greater invasiveness of the surgical treatment and the non-significant difference in terms of recurrence risk between the two techniques, endovascular treatment could be proposed as a first choice treatment; in the event of a recurrence, a surgical intervention will instead be proposed in a short time.
Identifiants
pubmed: 37082364
doi: 10.3389/fsurg.2023.1148968
pmc: PMC10111007
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1148968Informations de copyright
© 2023 Vercelli, Minardi, Bergui, Zenga, Garbossa and Cofano.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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