Clinical results after the multidisciplinary treatment of spinal arteriovenous fistulas

Purpose We retrospectively evaluated the clinical outcome after multidisciplinary treatment of spinal arteriovenous fistulas (AVFs) in terms of the Aminoff-Logue grading scale (ALS) to depict the outcome in a perspective pertinent to the quality of everyday living. Materials and methods Twenty-six s...

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Bibliographic Details
Published in:Japanese journal of radiology 2013-07, Vol.31 (7), p.455-464
Main Authors: Inagawa, Shoichi, Yamashita, Shuhei, Hiramatsu, Hisaya, Kamiya, Mika, Tanaka, Tokutaro, Sakahara, Harumi, Aoyama, Hidefumi
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angiography - methods
Arteriovenous Fistula - diagnostic imaging
Arteriovenous Fistula - therapy
Central Nervous System Vascular Malformations - diagnostic imaging
Central Nervous System Vascular Malformations - therapy
Embolization, Therapeutic
Female
Gait Disorders, Neurologic - classification
Humans
Imaging
Infant
Male
Medicine
Medicine & Public Health
Middle Aged
Nuclear Medicine
Original Article
Radiology
Radiotherapy
Retrospective Studies
Treatment Outcome
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Summary:Purpose We retrospectively evaluated the clinical outcome after multidisciplinary treatment of spinal arteriovenous fistulas (AVFs) in terms of the Aminoff-Logue grading scale (ALS) to depict the outcome in a perspective pertinent to the quality of everyday living. Materials and methods Twenty-six spinal AVFs in 25 patients were angiographically diagnosed from April 1998 through April 2012 and treated by endovascular embolization or surgery. When both treatment procedures seemed feasible, embolization was undertaken as the initial treatment. Motor and gait disturbance at follow-up was retrospectively graded according to ALS. Results All lesions were localized at the thoracolumbar or sacral levels and include six epidural AVFs with intradural venous reflux, 14 dural AVFs, and six perimedullary AVFs. Embolization was performed as the initial treatment for 17 lesions, while open surgery was performed for the others as well as for residual or recurrent lesions after embolization. All lesions were completely occluded except three perimedullary AVFs. At clinical follow-up of 1–153 months (mean 53.3), amelioration of gait disturbance with reduction of ALS scores was noted for 13 lesions and amelioration of micturition for 13 lesions as well. Conclusion Clinical functional status was improved for half of the lesions after the multidisciplinary treatment.
ISSN:1867-1071
1867-108X
DOI:10.1007/s11604-013-0216-6