Embolization of spinal dural arteriovenous fistula with polyvinyl alcohol particles: Experience in 14 patients

D. A. Nichols, D. A. Rufenacht, C. R. Jack, G. S. Forbes

Research output: Contribution to journalArticle

94 Scopus citations

Abstract

Purpose: To assess the effectiveness, initial and long term, of embolization using polyvinol alcohol particles (PVA) particles in patients with spinal dural arteriovenous fistulas (SDAVF). Methods: The initial treatment in 14 patients with SDAVF was embolization with PVA particles. Postembolization occlusion of the SDAVF was documented angiographically in all cases. Results: All 14 patients initially showed an improvement in clinical symptoms, but the neurologic status of 11 patients subsequently deteriorated. Of the 11 patients who had recurrence of symptoms, nine had angiographically proven recurrences of their SDAVF while two had negative follow-up of spinal angiography. PVA embolization is ineffective for the treatment of SDAVF and is not without risk. Conclusion: On the basis of a literature review of the other two alternative treatments (operation or liquid adhesive embolization) available for SDAVF and our preliminary experience with N-butyl cyanoacylate (NBCA) embolization, we suggest that NBCA embolization be the initial treatment of choice for SDAVF; if that procedure is not possible, or is unsuccessful, then operation is recommended.

Original languageEnglish (US)
Pages (from-to)933-940
Number of pages8
JournalAmerican Journal of Neuroradiology
Volume13
Issue number3
StatePublished - Jan 1 1992

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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