Transarterial Embolization for Spinal Dural Arteriovenous Fistula Assisted by a Balloon Placed at a Different Level of a Segmental Artery: A Case Report

抄録

Objective: We report a case of a spinal dural arteriovenous fistula (s-dAVF) involving feeders from multiple intervertebral levels. Transarterial glue embolization was performed with controlling the blood flow from a feeder other than the one through which n-butyl-2-cyanoacrylate (NBCA) was injected using a balloon placed at a different level of a segmental artery. With this technique, complete occlusion was achieved with satisfactory penetration of NBCA.

Case Presentation: A 57-year-old male presented with progressive gait disturbance and bladder bowel dysfunction. DSA revealed an s-dAVF fed by the right 6th, 7th, and 8th intercostal arteries (ICAs). During injection of NBCA from the radicular artery of the 6th ICA, the blood flow was controlled by occluding the feeder from the right 7th ICA with NBCA and a balloon placed at the orifice of the feeder from the right 8th ICA. Complete occlusion of the fistula was achieved by the balloon-assisted injection of NBCA.

Conclusion: NBCA injection with flow control using a balloon placed in a feeder from a different segmental artery was useful for the treatment of an s-dAVF fed by multiple segmental arteries.