EMBOLIZATION OF THE FIRST THREE SPINAL CORD AVM-CASES IN THAILAND

Abstract

PURPOSE: To embolize the spinal cord arterio-venous malformation (SCAVM), by transarterial superselective microcatheterization and injection of N-butyl cyano-acrylate (NBCA) as the permanent embolic material; were performed under prompt anatomical analysis. PATIENTS; MATERIALS AND METHODS: Three patients with SCAVM were treated with NBCA embolization into the arterial feeders as close to the nidus or shunt as possible. Superselective catheterization with microcatheter in co-axial system technique was used. Immediate control post embolization angiogram were performed in all cases with pre and post embolization evaluation of signs and symptoms. RESULTS: All three SCAVMS were technically successful embolized with good anatomical post embolization controlled angiogram. Clinical signs and symptoms were improved without any complications in two patients. A patient got immediate complication of the weakness of upper extremities with remaining minor motor deficit of the right hand at 1 year follow up. CONCLUSION: Transarterial superselective embolization of the SCAVM using NBCA as permanent liquid embolic material; under prompt anatomical and hemodynamic analysis; has recently been one of the most appropriate and effective way for the treatment of SCAVM; which most of them are non surgical lesions.