ArticleNeuroradiology2024
Angiographic challenges of spinal dural and epidural arteriovenous fistulas: report on 45 cases.
Article in Neuroradiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Single-position surgery with intraoperative digital subtraction angiography via a transpopliteal approach for complex spinal vascular lesions: illustrative cases.Journal of neurosurgery. Case lessons · 2026Article
- Multimodal MRI features of spinal perimedullary versus dural arteriovenous fistulas: an exploratory analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Spinal arteriovenous fistulas supplied by branches of internal iliac artery: clinical features and endovascular treatment outcomes.Acta neurochirurgica · 2026Article
- The Role of Angiographic Imaging in the Treatment of Spinal Vascular Malformations.Medical sciences (Basel, Switzerland) · 2025Review
- Pathology of the conus medullaris and cauda equina. Beyond the usual suspects.Insights into imaging · 2025Article
- Utility of T2-weighted MRI and contrast-enhanced MRA in locating the fistula level of spinal arteriovenous fistula.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
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3 authors.
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Abstract
purposeThe localization of the fistula level in spinal dural arteriovenous fistulas (dAVFs) and epidural arteriovenous fistulas (edAVFs) remains a diagnostic challenge.
methodsConsecutive patients with spinal dAVFs and edAVFs in the thoracic, lumbar, and sacral regions were included. The primary endpoint was to describe the characteristics of patients who required angiography with multiple catheterizations of segmental arteries (10 or more).
resultsForty-five patients (median age 69 years; male 89%; dAVFs, n = 31; edAVFs, n = 14) were included. Spinal dAVFs commonly developed in the thoracic region and edAVFs in the lumbosacral region. Fistulas were predicted at the correct level or plus/minus 2 level in less invasive examinations using multi-detector CT angiography (n = 28/36, 78%) and/or contrast-enhanced MR angiography (n = 9/14, 64%). We encountered diagnostic challenges in the localization of fistulas in 6 patients. They underwent angiography a median of 2 times. In each patient, spinal levels were examined at a median of 25 levels with a median radiation exposure of 3971 mGy and 257 ml of contrast. Fistulas were finally localized at the high thoracic region (T4-6) in 3 patients, the sacral region (S1-2) in 2, and the lumbar region (L3) in 1. Four patients were diagnosed with edAVFs and 2 with dAVFs. The correlation coefficient between the fistula level and the rostral end of the intramedullary T2 high-signal intensity on MRI was interpreted as none.
conclusionIn patients in whom less invasive examinations failed for fistula localization, high thoracic or sacral AVFs need to be considered.
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