{"id":"6ae7d4a2-008f-44ee-86bb-42c259f31659","slug":"treatment-of-23-spinal-perimedullary-arteriovenous-fistulas-in-a-single-center-a-simple-and-practical-treatment-strategy","title":"Treatment of 23 spinal perimedullary arteriovenous fistulas in a single center: A simple and practical treatment strategy","authors":["Hon-Man Liu","Chung-Wei Lee","Yen-Heng Lin"],"abstract":"Background: The aim of the study is to present our strategy for stratifying patients with spinal perimedullary arteriovenous fistulas (PMAVFs) and apply the appropriate treatment. Methods: This retrospective study included 23 patients with PMAVF. We divided the patients into three groups according to the location of the fistula and size of the predominant feeder: Group 1 (dorsal PMAVF, n = 4), Group 2 (nondorsal PMAVF having a predominant feeder through which the smallest coil-deploying microcatheter could pass, n = 6), and Group 3 (nondorsal PMAVF having no feeder through which the smallest available microcatheter could pass, n = 13). Group 1 underwent surgical treatment. All patients in Groups 2 and 3 underwent endovascular treatment with a liquid embolic agent, except one in Group 3, who opted for surgical treatment. Coil was used as a supplementary tool for treating lesions in Group 2. Patients’ basic and clinical characteristics, treatment, and outcome data were recorded. Results: Six patients were aged n = 11), conus region (n = 7), and cervical spine (n = 5). Of the 18 PMAVFs who underwent endovascular treatment, 100% occlusion was observed in 14, 90% in 3, and 75% in 1. Nineteen patients had complete or partial recovery of neurological deficits. Six patients experienced temporary worsening immediately after treatment but recovered within 3 months. No bleeding or rebleeding was noted after either treatment. Conclusion: Our simple strategy for stratifying PMAVF for treatment is easy to apply in clinical practice and results in favorable outcomes.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/6ae7d4a2-008f-44ee-86bb-42c259f31659/featured/hero-1781558612126.png","publishDate":"2025-05-23T00:00:00.000Z","doi":"10.25259/SNI_133_2025","categories":["Neurovascular","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2025/05/13573/SNI-16-196.pdf"}