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DOI: 10.1055/s-2002-34352
Successful Endovascular Treatment of a Spinal Dural Arteriovenous Fistula with Trisacryl Gelatin Microspheres
Publication History
Publication Date:
26 September 2002 (online)
Abstract
We report on the endovascular treatment of a spinal dural arteriovenous fistula (SDAVF) in a 50-year-old man, who presented with rapidly progressive paraparesis of lower extremities. Standard treatment of SDAVFs is by either embolization with liquid adhesive agents like NBCA or microsurgery. In our case the fistula was successfully occluded by application of trisacryl gelatin microspheres (TGM). Due to a small size of the feeding intercostal artery a superselective catheterization of the fistula itself by a microcatheter could not be performed. The particles were hence delivered through a diagnostic spinal catheter positioned within the proximal part of the feeding intercostal artery. Control MRI five weeks after intervention showed normalized perimedullary veins, which were dilated and tortuous initially. It also displayed a clinically silent focal ischaemia within the spongiosa of an adjacent hemi-vertebra due to particle passage through intersegmental vascular collaterals. A control angiogram confirmed the disappearance of the fistula. The patient underwent physiotherapy and experienced significant improvement of his gait within three months after intervention.
Key words
Spinal Dural Arteriovenous Fistula - Endovascular Embolization - Trisacryl Gelatin Microspheres - Focal Hemi-vertebra Ischaemia
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Dr. med. S. O. Rodiek
Department of Radiology · Academic Hospital München-Bogenhausen
Englschalkingerstr. 77
81925 Munich · Germany
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