Onyx embolization of a spinal epidural hemorrhage caused by thoracic spinal epidural arteriovenous fistula:A case report and literature review  

作　　者：Xi Chen Liang Ge Hailin Wan Lei Huang Yeqing Jiang Gang Lu Xiaolong Zhang 

机构地区：[1]Department of Radiology,Huashan Hospital,Fudan University,Shanghai,200040.China

出　　处：《Journal of Interventional Medicine》2022年第2期111-115,共5页介入医学杂志（英文）

基　　金：the National Natural Science Foundation of China (Grant No. 81771242)。

摘　　要：Spinal epidural hemorrhages(SEDH)caused by spinal epidural arteriovenous fistulas(SEAVFs)are rare;thus,their specific pathogenesis has not been explained.Furthermore,the standard treatment for SEAVFs has not yet been defined.Here we report the case of a 36-year-old Chinese man who experienced acute onset chest pain and tightness.His symptoms rapidly aggravated until the lower limbs were unable to support him.Spinal magnetic resonance angiography(MRA)revealed a localized SEAVF and a secondary spinal cord lesion at the T4 level.Digital subtraction angiography(DSA)confirmed the presence of the SEDH/SEAVF at the T3–4 level with the left radicular artery feeding the fistula.Based on DSA and MRA findings,SEDH,local spinal cord infarction,and spinal venous reflux disorder were conditionally diagnosed.Using the arterial route,Onyx-34 was injected into the fistula to embolize the feeding arteries and the venous system.Angiography was performed after the microcatheter was withdrawn,and no residual fistula or anterior spinal artery was observed.The six-week follow-up MRI showed acceptable healing of the SEAVF,and the patient improved neurologically.This case suggests that endovascular treatment with Onyx-34 embolization should be considered a promising treatment strategy for this type of complicated SEAVF.

关 键 词：Endovascular therapy Spinal epidural arteriovenous fistula Spinal epidural hemorrhage 

分 类 号：R651[医药卫生—外科学]