Treatment of Spinal Arteriovenous Malformation and Fistula

Neurosurg Clin N Am. 2022 Apr;33(2):193-206. doi: 10.1016/j.nec.2021.11.005.

Abstract

With the rapid advancements in endovascular therapy over previous decades, the treatment of spinal arteriovenous malformations (AVMs) continues to evolve. The decision to use endovascular versus surgical therapy largely depends on the type of lesion and its anatomic location. Recent studies demonstrate that endovascular treatment is effective for extradural arteriovenous fistulas (AVFs), intradural ventral (perimedullary) AVMs, and intramedullary spinal AVMs. Treatment of intradural dorsal (dural) AVFs remains largely surgical because of lower recurrence rates, although recent studies demonstrate equivocal outcomes. Extradural-intradural (juvenile) AVMs and conus AVMs remain difficult-to-treat lesions.

Keywords: Embolization; Endovascular; Fistula; Malformation; Spinal arteriovenous.

Publication types

  • Review

MeSH terms

  • Arteriovenous Fistula* / surgery
  • Arteriovenous Malformations* / diagnostic imaging
  • Arteriovenous Malformations* / surgery
  • Central Nervous System Vascular Malformations* / pathology
  • Central Nervous System Vascular Malformations* / surgery
  • Humans
  • Spinal Cord / pathology
  • Spinal Cord / surgery