TY - JOUR
T1 - Embolization of spinal dural arteriovenous fistula with polyvinyl alcohol particles
T2 - Experience in 14 patients
AU - Nichols, D. A.
AU - Rufenacht, D. A.
AU - Jack, C. R.
AU - Forbes, G. S.
PY - 1992/1/1
Y1 - 1992/1/1
N2 - 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.
AB - 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.
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M3 - Article
C2 - 1590193
AN - SCOPUS:0026648244
SN - 0195-6108
VL - 13
SP - 933
EP - 940
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 3
ER -