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- W2789872917 abstract "Spinal arteriovenous fistulae are an uncommon cause of myelopathy that require a high degree of suspicion to diagnose. Magnetic resonance imaging findings are often nonspecific, and the spinal angiogram can be technically demanding and prone to false negative findings if not sufficiently thorough. Type IV spinal vascular malformations, also known as ventral intradural arteriovenous fistulae, consist of a direct fistula between the anterior spinal artery and a perimedullary vein.1,2,3 This video demonstrates the angiographic diagnosis and microsurgical treatment of a Type IV malformation of the filum terminale. Informed consent was provided; Institutional Review Board approval was not applicable. The patient presented with 1 mo of progressive myelopathy. The angiographic diagnosis was aided by first performing time-resolved magnetic resonance angiography (4D-MRA), which helped us to focus the angiogram on the left T11 segmental artery that fed the fistula via the artery of Adamkiewicz. Selective catheterization of the artery of Adamkiewicz and sustaining the angiographic run for a sufficient duration were necessary to overcome the slow flow through the lesion and demonstrated a type IV malformation of the filum terminale, with the fistula at the L5 level. This lesion was treated by microsurgical ligation. After posterior midline exposure at the L5 level, dural opening, and arachnoid dissection, the fistula was identified adjacent to the filum terminale. The feeding artery and draining vein were coagulated and divided. The patient experienced symptomatic improvement postoperatively.Watch now at https://academic.oup.com/ons/article-lookup/doi/10.1093/ons/opx300 {href:Single Video Player,role:media-player-id,content-type:play-in-place,position:float,orientation:portrait,label:Diagnosis and Microsurgical Ligation of an Intradural Ventral (Type IV) Arteriovenous Fistula of the Filum Terminale: 3-Dimensional Operative Video,caption:,object-id:[{pub-id-type:doi,id:},{pub-id-type:other,content-type:media-stream-id,id:1_hq7zd35l},{pub-id-type:other,content-type:media-source,id:Kaltura}]} Disclosure The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article." @default.
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- W2789872917 date "2018-02-16" @default.
- W2789872917 modified "2023-09-27" @default.
- W2789872917 title "Diagnosis and Microsurgical Ligation of an Intradural Ventral (Type IV) Arteriovenous Fistula of the Filum Terminale: 3-Dimensional Operative Video" @default.
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- W2789872917 doi "https://doi.org/10.1093/ons/opx300" @default.
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