Spinal dural arteriovenous fistulas: Clinical experience with endovascular treatment as a primary therapeutic modality

Sung Bae Park, Moon Hee Han, Tae An Chang, Bae Ju Kwon, Chun Kee Chung

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16 Scopus citations

Abstract

Objective: The aim of this study was to evaluate the efficacy of endovascular therapy as a primary treatment for spinal dural arteriovenous fistula (DAVF). Methods: The authors reviewed 18 patients with spinal DAVFs for whom endovascular therapy was considered as an initial treatment at a single institute between 1993 and 2006. NBCA embolization was considered the primary treatment of choice, with surgery, reserved for patients in whom endovascular treatment failed. Results: Surgery was performed as the primary treatment in one patient because the anterior spinal artery originated from the same arterial pedicle as the artery feeding the fistula. Embolization was used as the primary treatment modality in 17 patients, with an initial success rate of 82.4%. Two patients with incomplete embolization had to undergo surgery. One patient underwent multiple embolizations, which failed to completely occlude the fistula but relieved the patient's symptoms. Spinal DAVF recurred in two patients (one collateral development and one recanalization) during the follow-up period. The collateral development was obliterated by repeated embolization, but the patient with recanalization refused further treatment. The overall clinical status improved in 15 patients (83.3%) during the follow-up period. Conclusion: Endovascular therapy can be successfully used as a primary treatment for the majority of patients with spinal DAVFs. Although it is difficult to perform in some patients, endovascular embolization should be the Primary treatment of choice for spinal DAVF.

Original languageEnglish
Pages (from-to)364-369
Number of pages6
JournalJournal of Korean Neurosurgical Society
Volume44
Issue number6
DOIs
StatePublished - 1 Dec 2008

Keywords

  • Dural arteriovenous fistula
  • Spine
  • Therapeutic embolization

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