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Long-term outcomes after surgical and endovascular treatment of spinal dural arteriovenous fistulae

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Title: Long-term outcomes after surgical and endovascular treatment of spinal dural arteriovenous fistulae
Authors: Sasamori, Toru Browse this author →KAKEN DB
Hida, Kazutoshi Browse this author
Yano, Shunsuke Browse this author
Asano, Takeshi Browse this author
Seki, Toshitaka Browse this author
Houkin, Kiyohiro Browse this author →KAKEN DB
Keywords: spinal dural arteriovenous fistulae
embolization
multidisciplinary management
long-term outcome
Issue Date: Mar-2016
Publisher: Springer
Journal Title: European spine journal
Volume: 25
Issue: 3
Start Page: 748
End Page: 754
Publisher DOI: 10.1007/s00586-015-3887-0
PMID: 25801745
Abstract: Purpose: To examine the validity of our treatment strategy for spinal dural arteriovenous fistulae (SDAVF), based on the treatment results and the long-term outcome. Methods: This study included 50 SDAVF patients (38 men, 12 women, mean age 63.2 years) with progressive myelopathy. The treatment strategy involved embolization as the initial management tool and surgery if embolization was considered unsuitable. Their medical records were evaluated to identify the treatment results and functional outcomes. The mean follow-up period was 81.2 months (range 27 - 184 months). Results: Complete obliteration was achieved in 22 (71.0%) of 31 embolized patients and in 18 of 19 (94.7%) operated patients. The initial success rate was significantly lower in embolized- than operated patients. At the last follow-up, 33 of the 50 patients (66%) manifested improved gait and 16 (32%) improved micturition. The activity of daily living (ADL) was improved in 33 (66%). When we compared the rates of functional improvement at the last follow-up, there was no significant difference between patients treated initially by embolization or surgery. Conclusions: The long-term outcomes in SDAVF patients treated by multidisciplinary management with first-line embolization were comparable to those in earlier surgical series. However, our results were unable to demonstrate the superiority of endovascular embolization to surgical treatment for SDAVF. For the purpose of justifying endovascular embolization as a first-line treatment for SDAVF, it will be necessary to show further improvement in both the initial treatment success and the complication rates.
Rights: The final publication is available at link.springer.com
Type: article (author version)
URI: http://hdl.handle.net/2115/64636
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 笹森 徹

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