Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA.
Department of Radiology, University of Minnesota, Minneapolis, MN, USA.
Interv Neuroradiol. 2024 Apr;30(2):288-292. doi: 10.1177/15910199221135052. Epub 2022 Oct 26.
Spinal angiography (SpAn) is the gold standard for diagnosis of spinal dural fistulas and arteriovenous malformations. A complete spinal angiogram necessitates the interrogation of the segmental arteries arising from the aorta at every level as well, the internal iliac; and median sacral arteries at the caudal end; and the cervical vasculature at the cranial end. SpAn has traditionally been performed with transfemoral arterial access and could be challenging. Of late, transradial arterial access has emerged as a popular alternative for endovascular surgical Neuroradiology (ESN) procedures including SpAn. However, there is paucity of the literature regarding transradial access for spinal angiography.
After IRB approval, records and imaging were reviewed in a series of patients who underwent SpAn at our institution.
A total of nine spinal angiograms were performed via transradial access in a consecutive series of eight patients between July 2019 and December 2020 at our institution. Eight of these were diagnostic SpAn's, and one patient underwent SpAn with transradial approach for the treatment of a type I spinal dural arteriovenous fistula. No complications occurred during or subsequent to the procedures.
SpAn can be successfully and safely accomplished via transradial access. This approach appears to provide a stable method for interventions, as well.
脊髓血管造影(SpAn)是诊断脊髓硬脑膜瘘和动静脉畸形的金标准。完整的脊髓血管造影需要在每个节段从主动脉以及髂内动脉、尾端的正中骶动脉和颅端的颈脉进行询问。SpAn 传统上采用经股动脉入路进行,可能具有挑战性。最近,经桡动脉入路已成为包括 SpAn 在内的血管内外科神经放射学(ESN)手术的一种流行替代方法。然而,关于经桡动脉入路进行脊髓血管造影的文献很少。
在获得机构审查委员会批准后,我们对在我院进行 SpAn 的一系列患者的记录和影像进行了回顾。
在我院,2019 年 7 月至 2020 年 12 月期间,连续 8 例患者共进行了 9 次经桡动脉入路的脊髓血管造影。其中 8 例为诊断性 SpAn,1 例患者经桡动脉入路进行 SpAn 治疗 I 型脊髓硬脑膜动静脉瘘。在手术过程中和手术后均未发生并发症。
SpAn 可以通过经桡动脉入路成功且安全地完成。这种方法似乎也为介入治疗提供了一种稳定的方法。