Results of the surgical treatment of perimedullary arteriovenous XXXX with special reference to embolization.

@entity1 @entity887 @entity292 @entity2548
OBJECT: This retrospective study was performed to evaluate the results of surgical treatment and the use of preoperative embolization in managing @entity1 with perimedullary arteriovenous @entity292 (AVFs). METHODS: The authors studied 20 consecutive @entity1 with perimedullary AVFs who underwent surgical treatment. Arteriovenous shunts were at the level of the cervical spine in five @entity1 , the thoracic spine in 12, and the conus medullaris in three @entity1 . Of the 20 AVFs, three were fed by the anterior spinal artery only, three by the posterior spinal artery, and 14 by both the anterior and posterior spinal arteries. Nine @entity1 had varices that compressed the spinal cord. Eleven @entity1 underwent surgery, and nine @entity1 underwent surgery combined with adjuvant preoperative embolization. @entity887 remarkably reduced blood flow through the AVFs and facilitated subsequent surgical procedures. Postoperative angiography revealed @entity2548 in 16 @entity1 . However, small @entity292 persisted in the other four @entity1 , whose large lesions were fed by the anterior spinal artery. Postoperatively, neurological status was improved in 11 @entity1 , unchanged in eight, and worse in one @entity1 . CONCLUSIONS: Effective interruption of a spinal arteriovenous shunt was achieved by surgery in all cases, even when the anterior spinal artery was involved. For large and high-flow AVFs, embolization proved to be a useful adjunct to surgery.
