Riché M C, Melki J P, Merland J J
AJNR Am J Neuroradiol. 1983 May-Jun;4(3):378-81.
During a 3 year period, 21 patients with spinal cord vascular malformations involving the anterior spinal artery were treated by embolization through this artery. Of four cases of extramedullary arteriovenous fistula, two patients embolized at an early stage showed excellent results, whereas results were mediocre in two patients who were paraplegic at embolization. Of 17 cases of intramedullary arteriovenous malformation (AVM), nine patients showed clinical improvement either with or without radiologic evidence of residual malformation; three patients had complications that led to clinical worsening; in the other five patients, results were mixed or inconclusive. Angiomyelotomography is recommended to diagnose extramedullary arteriovenous fistulae involving the anterior spinal artery. Pretherapeutic evaluation of intramedullary AVMs must consider the spinal cord level at which the malformation occurs. Angiotomography and temporary occlusion tests permit identification of collateral anastomoses before embolization. Respective criteria for surgery and embolization are defined. In cases where embolization is indicated, short-term results can generally be predicted.
在3年期间，21例累及脊髓前动脉的脊髓血管畸形患者通过该动脉进行栓塞治疗。在4例髓外动静脉瘘病例中，2例早期接受栓塞治疗的患者效果极佳，而另外2例在栓塞时已截瘫的患者效果一般。在17例髓内动静脉畸形（AVM）病例中，9例患者无论有无残留畸形的影像学证据均有临床改善；3例患者出现并发症导致临床症状恶化；另外5例患者的结果好坏参半或尚无定论。推荐采用血管脊髓造影术诊断累及脊髓前动脉的髓外动静脉瘘。髓内AVM的治疗前评估必须考虑畸形发生的脊髓节段。血管造影术和临时阻断试验可在栓塞前识别侧支吻合。明确了手术和栓塞的各自标准。在需要进行栓塞的病例中，一般可以预测短期结果。
