Eight spinal arteriovenous malformations were treated with Tracker-18 and/or Tracker-10 minicatheter and 180 to 350μm polyvinyl alcohol particles (Ivalon). These malformations included 4 glomus, 1 juvenile, and 3 dural arteriovenous fistulas. The artificial embolization was conducted introducing the minicatheter near to the nidus or fistulas and injecting Ivalon in a flow-directed manner. During and after the intravascular treatment, these patients were carefully examined. Four patients showed marked neurological improvement just after the treatment. The other four patients, who manifested severe paraparesis before the treatment, showed either slight improvement or no change in their neurological state after the procedure. One patient with glomus-type malformations fed by intrinsic spinal cord arteries via the Adamkiwicz artery, was successfully treated preserving the important artery. On post-embolization spinal angiograms, the nidus or fistulas itself was occluded in the all patients. In summary, superselective catheterization with Tracker-18 and/or Tracker-10 minicatheter, and artificial embolization with Ivalon are paramount therapy in the management of spinal arteriovenous malformations, especially juvenile- and glomus-type malformations, because surgical intervention is thought to be difficult and embolization proximal to or at the radicular artery occasionally induces newly developed collaterals to the malformations via extra and/or intradural anastomosis.
