Transvenous Embolization of a Ventral Spinal Pial Arteriovenous Fistula: A Technical Note.

Abstract

Spinal pial arteriovenous fistulas (SPAVFs) are abnormal intradural vascular connections between arteries and veins on the pial surface and lead to debilitating neurological deficits due to direct or indirect affection of the spinal cord. Open surgery and transarterial embolization offer a cure in most cases; however, some lesions can be very challenging and carry extremely high interventional risks. We aimed to provide a technical overview of a transvenous endovascular approach in treating an SPAVF. We present a 65-year-old male diagnosed with SPAVF and progressive neurological worsening. The SPAVF was evaluated with multiple imaging modalities and occluded completely using a transvenous route. We describe the concept of transvenous embolization of a ventral SAPV as an alternative to surgical occlusion or transarterial embolization.