Chung Bora, Roh Jieun, Lee Su Hun, Baik Seung Kug
Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
Neurointervention. 2025 Jul;20(2):99-104. doi: 10.5469/neuroint.2025.00346. Epub 2025 Jun 5.
We present a case of a patient in their 50s with a spinal epidural arteriovenous fistula (SEDAVF) at L2 level with intradural venous reflux. Initial transarterial embolization was attempted but failed due to vessel tortuosity and vasospasm. The second embolization was carried out with percutaneous puncture of the epidural venous sac under cone-beam computed tomography angiography (CBCTA) guidance. Following the complete obliteration of the fistula, resolution of the venous congestion and significant improvement of the patient's symptoms were achieved. This case highlights the utility of the percutaneous approach as an alternative treatment strategy for SEDAVFs when traditional endovascular routes are not feasible. Advanced imaging techniques, such as CBCTA, facilitate precise navigation and successful embolization.
我们报告一例50多岁患者，其L2水平存在伴有硬脊膜内静脉反流的脊髓硬膜外动静脉瘘（SEDAVF）。最初尝试经动脉栓塞，但由于血管迂曲和血管痉挛而失败。第二次栓塞是在锥形束计算机断层扫描血管造影（CBCTA）引导下经皮穿刺硬膜外静脉囊进行的。瘘完全闭塞后，静脉淤血得到缓解，患者症状显著改善。该病例突出了在传统血管内途径不可行时，经皮途径作为SEDAVF替代治疗策略的实用性。先进的成像技术，如CBCTA，有助于精确导航和成功栓塞。
