7 Diagnostic Spinal Angiography

2020 ◽  
Keyword(s):  
Spinal Angiography

Multisession CyberKnife Radiosurgery for Intramedullary Spinal Cord Arteriovenous Malformations

Neurosurgery ◽  
2006 ◽  
Vol 58 (6) ◽  
pp. 1081-1089 ◽  
Author(s):  
John Sinclair ◽  
Steven D. Chang ◽  
Iris C. Gibbs ◽  
John R. Adler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Arteriovenous Malformations ◽  
Conus Medullaris ◽  
Spinal Angiography ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord ◽  
Cyberknife Radiosurgery

Abstract OBJECTIVE: Intramedullary spinal cord arteriovenous malformations (AVMs) have an unfavorable natural history that characteristically involves myelopathy secondary to progressive ischemia and/or recurrent hemorrhage. Although some lesions can be managed successfully with embolization and surgery, AVM size, location, and angioarchitecture precludes treatment in many circumstances. Given the poor outlook for such patients, and building on the successful experience with radiosurgical ablation of cerebral AVMs, our group at Stanford University has used CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) to treat selected spinal cord AVMs since 1997. In this article, we retrospectively analyze our preliminary experience with this technique. METHODS: Fifteen patients with intramedullary spinal cord AVMs (nine cervical, three thoracic, and three conus medullaris) were treated by image-guided SRS between 1997 and 2005. SRS was delivered in two to five sessions with an average marginal dose of 20.5 Gy. The biologically effective dose used in individual patients was escalated gradually over the course of this study. Clinical and magnetic resonance imaging follow-up were carried out annually, and spinal angiography was repeated at 3 years. RESULTS: After a mean follow-up period of 27.9 months (range, 3–59 mo), six of the seven patients who were more than 3 years from SRS had significant reductions in AVM volumes on interim magnetic resonance imaging examinations. In four of the five patients who underwent postoperative spinal angiography, persistent AVM was confirmed, albeit reduced in size. One patient demonstrated complete angiographic obliteration of a conus medullaris AVM 26 months after radiosurgery. There was no evidence of further hemorrhage after CyberKnife treatment or neurological deterioration attributable to SRS. CONCLUSION: This description of CyberKnife radiosurgical ablation demonstrates its feasibility and apparent safety for selected intramedullary spinal cord AVMs. Additional experience is necessary to ascertain the optimal radiosurgical dose and ultimate efficacy of this technique.

Safety of spinal angiography

2011 ◽  
Vol 8 (1) ◽  
pp. 10-11 ◽  
Author(s):  
Michael C. Hurley ◽  
Timothy J. Carroll
Keyword(s):  
Spinal Angiography

Impact of non-contrast enhanced volumetric MRI-based feeder localization in the treatment of spinal dural arteriovenous fistula

2016 ◽  
Vol 9 (2) ◽  
pp. 178-182 ◽  
Author(s):  
Santhosh Kumar Kannath ◽  
Bejoy Thomas ◽  
P Sankara Sarma ◽  
Jayadevan Enakshy Rajan
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Definitive Treatment ◽  
Spinal Angiography ◽  
Vertebral Level ◽  
Spinal Dural Arteriovenous Fistula ◽  
Historical Cohort ◽  
Contrast Enhanced ◽  
The Impact

BackgroundThe preoperative localization of the feeder of spinal dural arteriovenous fistula (SDAVF) could simplify the diagnostic spinal angiographic procedure. Localization by non-contrast-enhanced MRI-based techniques is an attractive option. However, the usefulness of such an approach for evaluation of SDAVF has not yet been reported.ObjectiveTo study the impact of non-contrast MRI-based feeder localization, followed by targeted spinal angiography, in the evaluation of SDAVF before endovascular intervention.Materials and methodsProspectively collected data were analyzed and the level of the feeder was localized preoperatively. The procedural time for targeted spinal angiography was calculated and compared with that of a historical cohort, who underwent routine spinal angiographic examination before the study period. Follow-up MRI was carried out to assess the reliability of this model for detection of occasional metachronous lesions that might be missed with this approach.ResultsSeven patients underwent targeted spinal angiography during the study. The feeder level was accurately identified in five patients and was localized to one vertebral level in six patients. The correlation between MRI and DSA was statistically significant. The number of spinal levels assessed was fewer and overall procedure time was significantly shorter compared to historical cohort (58 min vs 162 min, respectively; p<0.001). Intervention was coupled with targeted angiography in two patients. Follow-up MRI demonstrated flow voids in one patient, who had recurrent fistula at one vertebral level below the previously embolized feeder.ConclusionsThe non-contrast MRI-based localization technique can reliably detect the level of feeder and help in therapeutic planning of SDAVF. The localization techniques potentially shorten the angiographic procedure and may facilitate simultaneous endovascular definitive treatment. Inclusion of follow-up MRI may be useful for detection of synchronous or metachronous lesions if a targeted approach is adopted. Additionally, this helps to identify failed endovascular therapy.

Robotic assistant spinal angiography: a case report and technical considerations

2021 ◽  
Vol 14 (3) ◽  
pp. 1-3
Author(s):  
Satoshi Tateshima ◽  
Hamidreza Saber ◽  
Geoffrey P Colby ◽  
Dieter Enzmann ◽  
Gary Duckwiler
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Spinal Angiography ◽  
Peripheral Vascular ◽  
Robotic Assisted ◽  
Prior Report ◽  
Early Case ◽  
Lumbar Spinal ◽  
Robotic Assistant ◽  
Technical Considerations

Robotic-assisted technology has shown to be promising in coronary and peripheral vascular interventions. Early case reports have also demonstrated its efficacy in neuro-interventions. However, there is no prior report demonstrating use of the robotic-assisted platform for spinal angiography. We report the feasibility of the robotic-assisted thoracic and lumbar spinal angiography.

SPINAL ANGIOGRAPHY IN THE PREOPERATIVE WORK-UP OF THORACOLUMBAR TRAUMA

1990 ◽  
Vol 83 (Supplement) ◽  
pp. 2S-69
Author(s):  
Jesse Rael ◽  
Lee Kesterson ◽  
Jerry King
Keyword(s):  
Spinal Angiography ◽  
Preoperative Work Up ◽  
Work Up

L4 to S1 motor neuron degeneration due to T11–T12 disc herniation with normal spinal angiography

2013 ◽  
Vol 115 (7) ◽  
pp. 1167-1169
Author(s):  
Guillaume Taieb ◽  
Dimitri Renard ◽  
Jean Pierre Hladky ◽  
Jean Baptiste Chevallier ◽  
Stephane Fuentes ◽  
...  
Keyword(s):  
Motor Neuron ◽  
Disc Herniation ◽  
Spinal Angiography ◽  
Motor Neuron Degeneration ◽  
Neuron Degeneration

Cavernous angioma of the cauda equina producing subarachnoid hemorrhage

1987 ◽  
Vol 66 (1) ◽  
pp. 134-136 ◽  
Author(s):  
Shinsuke Ueda ◽  
Akihito Saito ◽  
Shigeo Inomori ◽  
Ilu Kim
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cauda Equina ◽  
Cavernous Angioma ◽  
Low Back ◽  
Spinal Angiography ◽  
Resonance Imaging ◽  
Total Removal ◽  
Content Type ◽  
Similar Episode ◽  
Fine Print

✓ A case of a cavernous angioma of the cauda equina is presented. The patient was a 28-year-old man who experienced sudden low-back pain and headache without neurological symptoms. Lumbar puncture revealed subarachnoid hemorrhage. He had suffered a similar episode 3 years previously. Selective spinal angiography did not demonstrate any abnormal vascularity. Metrizamide myelography and magnetic resonance imaging were useful in demonstrating the presence of a tumor. Laminectomy at L1–3 and total removal of the tumor were performed without neurological deficit.

Microsurgical Treatment of Recurrent Conus Medullaris Arteriovenous Malformation: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (2) ◽  
pp. E44-E44
Author(s):  
M Neil Woodall ◽  
Robert F Spetzler
Keyword(s):  
Arteriovenous Malformations ◽  
Treatment Options ◽  
Conus Medullaris ◽  
Endovascular Embolization ◽  
Spinal Angiography ◽  
Microsurgical Treatment ◽  
Complete Obliteration ◽  
Retrospective Nature ◽  
Posterior Spinal Arteries

Abstract Arteriovenous malformations (AVMs) involving the conus medullaris have a unique angioarchitecture due to their involvement of the arterial basket of the conus medullaris, which represents an arterial anastomotic network between the anterior spinal artery (ASA) and posterior spinal arteries (PSAs) at the level of the conus medullaris.1 These lesions consist of a combination of a true AVM nidus, which is usually extramedullary, and direct shunts between the ASA, PSAs, and the venous system. Patients may present with radiculopathy, myelopathy, or subarachnoid hemorrhage.2 A 40-yr-old woman status post T11-L1 laminoplasty for resection of a ruptured conus AVM 6 yr prior presented with routine follow-up angiography suggestive of an arteriovenous fistula. She was counseled regarding treatment options including endovascular embolization and microsurgical ligation or resection, and she elected to proceed with surgical treatment. At the time of surgery, a recurrent AVM was noted. A 2-dimensional intraoperative video illustrates the microsurgical treatment of her recurrent conus AVM. The patient recovered well postoperatively. Spinal angiography demonstrated complete obliteration of the lesion. The patient experienced transient urinary retention that was self-limited but otherwise was without any new neurological deficit. Due to the retrospective nature of this report, informed consent was not required. Video used with permission from Barrow Neurological Institute, all rights reserved.

Treatment of spinal metastases from kidney cancer by presurgical embolization and resection

1990 ◽  
Vol 73 (4) ◽  
pp. 548-554 ◽  
Author(s):  
Narayan Sundaresan ◽  
In Sup Choi ◽  
James E. O. Hughes ◽  
Ved Prakash Sachdev ◽  
Alex Berenstein
Keyword(s):  
Radiation Therapy ◽  
Survival Rate ◽  
Blood Loss ◽  
Kidney Cancer ◽  
Spinal Metastases ◽  
Neurological Deficits ◽  
Spinal Angiography ◽  
Content Type ◽  
External Radiation Therapy ◽  
Angiography And Embolization

✓ Surgical treatment of bone metastases from kidney cancer is often complicated by profuse blood loss. The authors report the results of a retrospective review of 30 consecutive patients who underwent surgery for spinal metastases from kidney cancer. Seventeen patients (57%) were operated on after failing radiation therapy. Prior to operation, selective spinal angiography and embolization were performed in 17 patients with no permanent neurological deficits resulting. Gross total resection of the tumor and stabilization of the spine were then accomplished with acceptable blood loss. Twenty-seven (90%) of the 30 patients improved neurologically following surgery. There was a median survival time of 16 months, a 2-year survival rate of 33%, and a 5-year survival rate of 15%. Major surgical complications in this series were related to excessive blood loss in patients without embolization. These data suggest that patients with spinal metastases from kidney cancer should undergo spinal angiography and embolization prior to resection of the tumor. To improve upon current results, such treatment should be carried out prior to external radiation therapy.

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