Document Detail


N-butyl 2-cyanoacrylate embolization of spinal dural arteriovenous fistulae.
MedLine Citation:
PMID:  11158885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Because they are not well established, we investigated the technical success and recurrence rates of n-butyl 2-cyanoacrylate (NBCA) embolization of spinal dural arteriovenous fistulae (SDAVF), and assessed clinical outcomes. METHODS: We retrospectively studied all patients with SDAVF treated by NBCA embolization at our institution over an 8-year period. Gait and micturition disabilities were analyzed. Follow-up periods averaged 3.1 years (range, 1 month to 8.9 years). RESULTS: NBCA embolization was feasible in 74% (20/27) of patients. Of 20 patients who underwent embolization, initial embolization failure occurred in two (10%) and fistula occurrence in three (15%). All five patients in whom NBCA embolization failed underwent surgery. All patients who underwent embolization had either improved (55%) or unchanged (45%) gait disability at last follow-up. Seventeen (85%) patients had improved (40%) or unchanged (45%) micturition disability, but three (15%) had worsened. Mean Aminoff gait disability grade significantly decreased at last follow-up (2.4 [1.4] average [SD] vs 3.2 [1.4] [P = .0008]). Mean micturition disability grade decreased, but not significantly (1.4 [1.0] vs 1.7 [1.1] [P = .28]). CONCLUSION: NBCA embolization of SDAVF was technically feasible in 75% of patients. Initial apparent successful embolization was achieved in 90%; the fistula recurrence rate (failure to occlude the draining vein) for NBCA was 15%. Comparing favorably to surgical series, NBCA embolization of SDAVF appears efficacious, significantly improving mean gait disability by almost one grade at last follow-up. Close clinical and angiographic surveillance is mandatory. Longer and more uniform follow-up is needed to determine if clinical improvement and stabilization after NBCA embolization are sustained.
Authors:
J K Song; Y P Gobin; G R Duckwiler; Y Murayama; J G Frazee; N A Martin; F Viñuela
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  22     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-01-30     Completed Date:  2001-03-29     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-7     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of California at Los Angeles School of Medicine, 90095-1721, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography
Arteriovenous Fistula / diagnosis,  therapy*
Disability Evaluation
Dura Mater / blood supply*
Embolization, Therapeutic / methods*
Enbucrilate / analogs & derivatives,  therapeutic use*
Female
Gait
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Postoperative Period
Retrospective Studies
Spinal Cord / blood supply*
Treatment Outcome
Urination
Chemical
Reg. No./Substance:
6606-65-1/Enbucrilate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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