Endovascular treatment of spinal arteriovenous malformations

Waleed Brinjikji, Giuseppe Lanzino

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations

Abstract

Spinal arteriovenous malformations (AVMs) are a rare but treatable cause of myelopathy and spinal cord hemorrhage. The clinical presentation and ideal treatment of these lesions vary widely, primarily due to differences in anatomic and angioarchitectural features. Six well-defined types of fistula have been defined: (1) intradural dorsal AVM; (2) intramedullary AVM; (3) extradural-intradural AVM; (4) intradural ventral AVF; (5) extradural/epidural AVF; and (6) conus medullaris AVM. Each of these lesions have unique clinical presentations and variable natural histories and endovascular treatment options. The principles of endovascular treatment include: (1) a complete understanding of the angioarchitecture and anatomic features of the lesion, including identification of radiculomedullary arteries; (2) careful spinal angiography; (3) identification of treatment goals prior to the procedure (i.e., complete occlusion versus partial occlusion aimed at altering natural history); (4) selection of proper embolic agent; and (5) careful follow-up in both the immediate postoperative setting and long term.

Original languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages161-174
Number of pages14
Volume143
DOIs
StatePublished - 2017

Publication series

NameHandbook of Clinical Neurology
Volume143
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Keywords

  • embolization
  • endovascular
  • myelopathy
  • spinal arteriovenous malformation

ASJC Scopus subject areas

  • Medicine(all)
  • Neurology
  • Clinical Neurology

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