Ten-year retrospective study on the management of spinal arteriovenous lesions: efficacy of a combination of intra-operative digital subtraction angiography and intra-arterial dye injection.

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Ten-year retrospective study on the management of spinal arteriovenous lesions: efficacy of a combination of intra-operative digital subtraction angiography and intra-arterial dye injection.

World Neurosurg. 2017 May 23;:

Authors: Osanai T, Hida K, Asano T, Seki T, Sasamori T, Houkin K

Abstract
BACKGROUND: The goal of treatment for spinal arteriovenous lesions is to completely obliterate the shunt. In our institution, intra-operative digital subtraction angiography (IODSA) and intra-arterial injection of contrast agent have already been used to accurately identify the site of arteriovenous shunts.
OBJECTIVE: In this paper, we describe the IODSA and intra-arterial dye injection (IADI) procedures, and how they may improve surgical outcomes.
METHODS: We retrospectively investigated 22 patients with intra-dural arteriovenous lesions(n = 19) or spinal dural arteriovenous fistulae (SDAVFs) (n = 3). A microcatheter was used during the procedures to avoid catheter migration.
RESULTS: A total of 29 procedures were performed. To support the surgical procedures, Indigo carmine was used 17 times and Indocyanine green (ICG) was used 12 times. There were no complications associated with these procedures. The ICG procedure required a lower concentration of ICG in the artery than in the vein to clarify the shunt point, and visualized the complex lesions more clearly. Therefore, these methods allowed surgeons to orientate the complex vessel structure.
CONCLUSIONS: A combination of IODSA and IADI are useful tool for the management of spinal arteriovenous lesions .

PMID: 28549639 [PubMed - as supplied by publisher]

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