Question

Describe the endovascular treatment planning in spinal dural arterio-venous fistulae.

Hint:

Endovascular treatment is the preferred method for treating spinal dural arterio-venous fistulas due to its minimally invasive nature and effectiveness in occluding the abnormal vessels.

Answer 1

Step 1: Indication for Endovascular Treatment:
Endovascular treatment is typically the first-line approach for SDAVFs. The goal is to occlude the arteriovenous fistula while preserving the spinal cord's vascular supply. Endovascular embolization using detachable coils or liquid embolic agents is commonly employed.

Step 2: Procedure:
During the procedure, a catheter is introduced into the arterial system to reach the feeders of the fistula. The embolic material is then injected into the fistula to occlude the abnormal vascular connection. The procedure is usually performed under fluoroscopic guidance.

Step 3: Post-treatment Monitoring:
Post-treatment MRI and angiography are performed to confirm the complete closure of the fistula. Close monitoring for potential complications, such as spinal cord ischemia, is essential.