ArticleSurgical neurology international2026
Open microsurgery required to address failed endovascular embolization for a spinal dural arteriovenous fistula.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- A Case of Acute Spontaneous Spinal Epidural Hematoma Caused by Repeated Bleeding Thoracic Radiculomeningeal Artery.NMC case report journal · 2026Article
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7 authors.
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Abstract
Background: "Endovascular treatment (EVT)-first" strategies have been increasingly used to treat spinal dural arteriovenous fistulas (SDAVFs). Nevertheless, when EVT fails to penetrate the fistulous point and proximal draining vein, conversion to an open microsurgical approach is warranted. Case Description: A 52-year-old male presented with progressive myelopathy. The magnetic resonance imaging (MRI) showed spinal cord edema and dorsal flow voids at the T9 level; formal angiography demonstrated an SDAVF supplied by a radiculomeningeal artery and a single dorsal draining vein. Three-dimensional digital subtraction angiography (DSA) revealed a clear T-sign and caliber change suggesting a reachable shunt. However, when transarterial glue embolization was attempted, the embolic agent could not get past the nerve root sleeve, and, therefore, endovascularly, we could not reach the shunt. Further, we identified an additional new feeder originating from T8. Therefore, EVT was abandoned, and an open microsurgical approach was performed. Once the durotomy was completed, congested intradural "red vein" was identified; it was coagulated and ligated near its dural origin, resulting in complete fistula obliteration. Postoperatively, symptoms improved, and the MRI confirmed occlusion of the SDAVF with resolution of vascular congestion findings. Conclusion: Even when 3D-DSA indicates good access to a SDAVF shunt,
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