Clinical features and outcomes of spinal cord arteriovenous malformations: comparison between nidus and fistulous types.

Détails

ID Serval
serval:BIB_93DC45E04902
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Clinical features and outcomes of spinal cord arteriovenous malformations: comparison between nidus and fistulous types.
Périodique
Stroke
Auteur(s)
Lee Y.J., Terbrugge K.G., Saliou G., Krings T.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Statut éditorial
Publié
Date de publication
09/2014
Peer-reviewed
Oui
Volume
45
Numéro
9
Pages
2606-2612
Langue
anglais
Notes
Lee, Young-Jun
Terbrugge, Karel G
Saliou, Guillaume
Krings, Timo
eng
Comparative Study
2014/07/17 06:00
Stroke. 2014 Sep;45(9):2606-12. doi: 10.1161/STROKEAHA.114.006087. Epub 2014 Jul 15.
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
As a result of the rarity of spinal cord arteriovenous malformations (AVM), there are only a few series available that describe clinical features, outcome after treatment, and natural history of these lesions. In this article, we aim to describe our experience with both nidus- and fistulous-type spinal cord AVMs.
Forty-four consecutive patients with spinal cord AVMs were retrospectively reviewed. There were 26 patients with a nidus-type and 18 patients with a fistulous-type AVM. Treatments were performed with embolization (n=23), surgery (n=13), combined embolization-surgery (n=3), or conservative management (n=5). Clinical features, radiological findings, treatment results, and clinical outcomes were assessed.
Patients with nidus-type AVMs were younger at presentation and more often presented with hemorrhage, with a higher proportion of hematomyelia than fistulous-type AVMs (P<0.05). Progression of clinical presentation from hemorrhage to congestive myelopathy during follow-up was noted in 5 patients, all of which had AVMs of the nidus type. Complete obliteration could be achieved more often in the fistulous type (72%) than in the nidus type (27%). Improved or stable clinical status at last follow-up was noted in 100% of fistulous-type and 77% of nidus-type patients. Long-term clinical deterioration was noted in 6 of 26 patients with nidus-type (23%) AVMs and was related to recurrent bleeding (n=3) or progressive venous congestion (n=3). Overall rebleed rate after presentation with hemorrhage was 7 in 145.5 patient-years (4.8%/y) if the lesion was not treated, 3 in 102 patient-years (2.9%/y) after partial treatment, and 0 in 47.5 patient-years (0%) after complete treatment.
Nidus and fistulous spinal cord AVMs have different clinical features and obliteration rates, which may affect their long-term prognosis.

Mots-clé
Adolescent, Adult, Aged, Arteriovenous Fistula/diagnosis, Arteriovenous Fistula/therapy, Arteriovenous Malformations/diagnosis, Arteriovenous Malformations/therapy, Child, Disease Progression, Embolization, Therapeutic, Female, Hemorrhage/physiopathology, Humans, Male, Middle Aged, Prospective Studies, Retrospective Studies, Spinal Cord/physiopathology, Spinal Cord Diseases/pathology, Treatment Outcome, Young Adult
Pubmed
Création de la notice
20/01/2017 16:30
Dernière modification de la notice
03/03/2018 19:36
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