Author/Editor		Gory, Benjamin; Saleme, Suzana; Ayoub, David; Rouchaud, Aymeric; Šeruga, Tomaž; Boncoeur Martel, Marie Paule; Mounayer, Charbel
Title		Embolization of spinal dural arteriovenous fistula via the retrocorporeal artery
Type		članek
Vol. and No.		Letnik 73, št. suppl. Operative neurosurgery 2
Publication year		2013
Volume		str. E283-E286
ISSN		0148-396X - Neurosurgery
Language		eng
Abstract		Background and importance: The goal of spinal dural arteriovenous fistula (DAVF) treatment is to permanently occlude the proximal draining vein and the fistula itself, which can be achieved by open surgery or by endovascular treatment. The endovascular approach is currently the primary treatment, but it requires the presence of an access as close to the site of the fistula as possible. This case illustrates that the retro-corporeal artery may be an alternative option in case of previous embolization failure with proximal occlusion of the radicular arteries. Clinical presentation: A 54-year-old man presented with an 18-month history of progressive paraparesis secondary to right L2 spinal DAVF. The first endovascular treatment failed to achieve occlusion of the fistula via the ipsilateral L2 and L3 radicular arteries. Given the proximal occlusion of these feeders during the first embolization, the dilated retro-corporeal arteries were approached through the contralateral L2 and L3 radicular arteries. Complete occlusion of the fistula was achieved with Onyx in a single session with progressive improvement of preoperative neurological deficit. Conclusion: The retro-corporeal artery may provide a safe alternative approach to spinal DAVFs in cases where a conventional endovascular approach failed, thus avoiding invasive surgical treatment.
Keywords		arteriovenska fistula, duralno spinalna endovaskularna embolizacija vaskularne malformacije