Endovascular embolisation as minimally-invasive treatment for spinal dural arteriovenous fistulas-evaluation of long-term results

Aim of study. Spinal dural arteriovenous fistulas (sDAVF) are rare spinal cord lesions formed between a radicular artery and medullary vein leading to venous hypertension resulting in neurological impairment. Endovascular embolisation is a minimally-invasive method aiming to interrupt the shunt between the artery and vein. We report our experience with sDAVF treated endovascularly.Material and methods. Clinical and procedural data of 16 consecutive patients diagnosed with sDAVF was reviewed. Pre-and post-operative neurological condition was evaluated using both the Aminoff and Logue disability scale and the VAS scale. Rates of complete occlusions, technical difficulties, and procedural complications were noted.Results. Four of the patients were female and 12 were male; mean age was 62.4 years. Mean interval between symptom onset and treatment was 13.3 months. Complete occlusion was achieved in 88% (14/16 patients). Significant or moderate clinical improvement in long-term follow-up was observed in eight patients (50%). Recurrence was observed in two cases (13%).Conclusions and clinical implications. While endovascular methods are being refined and thus achieving an increasing percentage of successful occlusions, patients should be closely monitored since this condition is recurrent and the clinical consequences of myelopathy can persist despite complete occlusion of the shunt.