A single-center, long-term study of spinal dural arteriovenous fistulas with multidisciplinary treatment.
J Clin Neurosci
; 18(12): 1662-6, 2011 Dec.
Article
in En
| MEDLINE
| ID: mdl-22019434
ABSTRACT
Spinal dural arteriovenous fistulas (SDAVF) are the most frequently occurring vascular malformations of the spinal cord but their optimal treatment remains contentious. We retrospectively analyzed 19 consecutive patients treated between 1996 and 2007. Endovascular embolization was considered the first treatment option for nine patients. Ten patients did not fulfill the endovascular indications and underwent surgery. Four patients required a second treatment with surgery three following failed embolization and one following surgery. Clinical outcomes were assessed using the Aminoff-Logue disability scale (ALS). The mean follow-up time was 36 months (range=4-103 months). At follow-up, 79% of patients showed stabilization or improvement on the ALS. The overall efficacy of embolization was 55.6%, compared to 100% with surgery (p=0.03). Multidisciplinary treatment with embolization or surgery offers good long-term results. Whenever embolization does not ensure a complete closure of the venous side of the fistula, surgery should be considered as the first treatment because of its lower late recurrence rate.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord
/
Spinal Cord Diseases
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Central Nervous System Vascular Malformations
/
Embolization, Therapeutic
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
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Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
J Clin Neurosci
Journal subject:
NEUROLOGIA
Year:
2011
Document type:
Article
Affiliation country: