Please use this identifier to cite or link to this item:
https://doi.org/10.4103/2152-7806.125628
DC Field | Value | |
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dc.title | Comparison of surgical and endovascular approach in management of spinal dural arteriovenous fistulas: A single center experience of 27 patients | |
dc.contributor.author | Gokhale, S | |
dc.contributor.author | Khan, S.A | |
dc.contributor.author | McDonagh, D.L | |
dc.contributor.author | Britz, G | |
dc.date.accessioned | 2020-11-10T00:28:05Z | |
dc.date.available | 2020-11-10T00:28:05Z | |
dc.date.issued | 2014 | |
dc.identifier.citation | Gokhale, S, Khan, S.A, McDonagh, D.L, Britz, G (2014). Comparison of surgical and endovascular approach in management of spinal dural arteriovenous fistulas: A single center experience of 27 patients. Surgical Neurology International 5 (JAN) : 7. ScholarBank@NUS Repository. https://doi.org/10.4103/2152-7806.125628 | |
dc.identifier.issn | 21527806 | |
dc.identifier.uri | https://scholarbank.nus.edu.sg/handle/10635/183185 | |
dc.description.abstract | Background: Spinal dural arteriovenous fistula (SDAVF) is a rare spinal vascular malformation with an annual incidence of 5-10 cases per million. The data on efficacy, recurrence rates and complications of endovascular versus surgical treatment of SDAVF is limited. Methods: We conducted a retrospective chart review of 27 adult patients with a diagnosis of SDAVF and who underwent treatment at Duke University Hospital between January 1, 1993 and December 31, 2012. We compared the outcome measures by Aminoff-Logue score (ALS) in patients who underwent treatment with endovascular embolization versus surgical ligation of fistula. We compared complication rates, recurrence rates as well as data on long-term follow up in these patients. Results: Out of 27 patients in the study, 10 patients underwent endovascular embolization (Onyx was used in 5 patients and NBCA in 5 patients) as the first line therapy. Seventeen patients underwent surgical ligation as initial therapeutic modality. Patients in both groups showed significant improvement in clinical status (ALS) after treatment. One patient in endovascular group developed spinal infarction due to accidental embolization of medullary artery. Three patients in embolization group had recurrence of fistula during the course of follow up requiring surgical ligation. Two patients in surgical group developed local wound infection. None of the patients in surgical group had recurrence of fistula during the course of follow up. Conclusions: Endovascular embolization and surgical ligation are effective treatment strategies for SDAVF. Our observations show that surgical ligation may offer permanent cure without any recurrence. Endovascular approach is associated with higher incidence of recurrence, especially with use of onyx. Copyright: © 2014 Gokhale S. | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.source | Unpaywall 20201031 | |
dc.subject | adult | |
dc.subject | aged | |
dc.subject | Aminoff Logue scale | |
dc.subject | article | |
dc.subject | artificial embolism | |
dc.subject | clinical article | |
dc.subject | clinical effectiveness | |
dc.subject | comparative study | |
dc.subject | dural arteriovenous fistula | |
dc.subject | endovascular embolization | |
dc.subject | female | |
dc.subject | fistula | |
dc.subject | follow up | |
dc.subject | human | |
dc.subject | incidence | |
dc.subject | infection | |
dc.subject | long term care | |
dc.subject | male | |
dc.subject | outcome assessment | |
dc.subject | postoperative complication | |
dc.subject | priority journal | |
dc.subject | recurrent disease | |
dc.subject | retrospective study | |
dc.subject | scoring system | |
dc.subject | spinal dural arteriovenous fistula | |
dc.subject | spinal infarction | |
dc.subject | surgical approach | |
dc.subject | surgical ligation | |
dc.subject | wound infection | |
dc.subject | artery ligation | |
dc.subject | Article | |
dc.subject | artificial embolism | |
dc.subject | controlled study | |
dc.subject | dural arteriovenous fistula | |
dc.subject | infarction | |
dc.subject | intermethod comparison | |
dc.subject | medical record review | |
dc.subject | middle aged | |
dc.subject | pneumonia | |
dc.subject | recurrence risk | |
dc.subject | spinal cord infarction | |
dc.subject | surgical approach | |
dc.subject | therapy effect | |
dc.subject | treatment outcome | |
dc.subject | urinary tract infection | |
dc.subject | wound care | |
dc.subject | wound infection | |
dc.subject | young adult | |
dc.subject | antibiotic agent | |
dc.subject | enbucrilate | |
dc.subject | ethylene vinyl alcohol copolymer | |
dc.type | Article | |
dc.contributor.department | DUKE-NUS MEDICAL SCHOOL | |
dc.description.doi | 10.4103/2152-7806.125628 | |
dc.description.sourcetitle | Surgical Neurology International | |
dc.description.volume | 5 | |
dc.description.issue | JAN | |
dc.description.page | 7 | |
Appears in Collections: | Staff Publications Elements |
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