Percutaneous embolization of spinal cord arteriovenous malformations

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Abstract
✓ A technique is described for embolically occluding the feeding arteries of spinal cord arteriovenous malformations by non-operative means. Following the identification of each feeder by selective arteriography, a system of coaxial catheters is introduced percutaneously and each feeding artery is occluded within the spinal canal using metallic pellets, gelfoam, and muscle fragments. Technical details of the procedure are described and the choice of embolic material discussed. Embolization has been successfully accomplished in five patients. None were made worse, and three have shown progressive neurological improvement. The simplicity of the procedure and the absence of morbidity are stressed. Percutaneous embolization should be considered as an alternative to operative ligation of feeding arteries.