Materiały źródłowe

• #1 Spinal arteriovenous malformations

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-50442021000200077

  sAVMs make up the most common vascular anomaly of the spine, with an estimated proportion of 60-80%. sAVMs account for 3-4% of all intradural spinal cord mass lesions, and dural sAVMs are the most common vascular malformation, accounting for 50-85% of all lesions. […] Lad et al. analyzed National Inpatient Sample data from 1995 to 2006, screening admissions with a primary diagnostic code for spinal vascular malformation. In these 11 years, 3291 patients were admitted with a diagnosis of spinal vascular malformation, with an average of 299 annual admissions with a new diagnosis of sAVM; the majority of admissions corresponded to male patients (57%) in the 45-64-year age range (36% of admissions). […] Jellema et al. analyzed all reported series with more than five patients affected by direct sAVMs, detecting there were 968 men against 210 women (ratio almost 5:1). The mean age at the time of diagnosis was found to be 55-60 years; patients under the age of 30 were rarely reported (14 patients under age 30 were found in the 1178 patients or 1%). The youngest patients reported were 22 years at the time of diagnosis. In their study was concluded that no patient under the age of 20 has ever been reported.

• #2 Conus medullary arteriovenous malformation mimicking intramedullary tumor: a case report | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00553-y

  Spinal arteriovenous malformation (AVM) is often missed because of overlapping symptoms with other pathology and ambiguous imaging. […] Spinal arteriovenous malformation (AVM) is a type of vascular malformation of the spine composed of nidus with draining vein and feeding artery, accounting for 34% of all intradural spinal cord tumours. […] Despite advances in neuroimaging technology, vascular lesion diagnosis is often missed, because the symptoms usually overlap with more frequent cases of myelopathy, such as neoplasms and other spinal degenerative diseases. […] If left untreated, spinal AVM could cause significant and progressive neurological disability in a short time. […] Because of the similarity in epidemiology, symptoms, clinical progression, and imaging, suspicion of spinal AVM should remain.

• #3 Spinal arteriovenous malformations | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/spinal-arteriovenous-malformations?embed_domain=hackmd.io%2F%40yIPUAFeCSL2JsU8smR5nJQ%2Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.pngfavicon.icoradiopaedia-icon-144.pngfavicon.ico&lang=us

  Spinal arteriovenous malformations (AVMs) are characterized by arteriovenous shunting with a true nidus. They represent ~25% of spinal vascular malformations. […] Different types of spinal AVM have different ages of presentation, but overall 80% present between the age of 20 and 60 years. […] Both surgery and angioembolisation have a role in the treatment of spinal AVMs.

• #4

  https://scholars.duke.edu/publication/731190

  OBJECT: Spinal arteriovenous malformations (AVMs) are rare and understudied vascular lesions that cause neurological insult by mass effect, venous obstruction, and vascular steal. […] Trends in procedural management, hospital course, and epidemiology of spinal AVMs are investigated. […] Annually, an average of 300 patients presented with spinal AVMs requiring hospital treatment. […] The average length of hospital stay for this treatment has declined from more than 9 days in 1995 to 6 days in 2006. […] However, the average cost of a hospital stay has increased from $30,000 to nearly $70,000. […] Whereas one-half of spinal AVMs were treated operatively in 1995, one-third were managed operatively in 2006. […] Spinal AVMs are being increasingly treated by endovascular, radiosurgical, or combined means.

• #5 National trends in spinal arteriovenous malformations in: Neurosurgical Focus Volume 26 Issue 1 (2009) Journals

  https://thejns.org/focus/view/journals/neurosurg-focus/26/1/article-p1.xml

  Spinal arteriovenous malformations (AVMs) are rare and understudied vascular lesions that cause neurological insult by mass effect, venous obstruction, and vascular steal. Current management options include open microsurgery, endovascular embolization, and stereotactic radiosurgery. […] Trends in procedural management, hospital course, and epidemiology of spinal AVMs are investigated. […] Annually, an average of 300 patients presented with spinal AVMs requiring hospital treatment. […] The average length of hospital stay for this treatment has declined from more than 9 days in 1995 to 6 days in 2006. […] However, the average cost of a hospital stay has increased from $30,000 to nearly $70,000. […] Whereas one-half of spinal AVMs were treated operatively in 1995, one-third were managed operatively in 2006.

• #6 Spinal arteriovenous malformations

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-50442021000200077

  sAVMs make up the most common vascular anomaly of the spine, with an estimated proportion of 60-80%. sAVMs account for 3-4% of all intradural spinal cord mass lesions, and dural sAVMs are the most common vascular malformation, accounting for 50-85% of all lesions. […] Lad et al. analyzed National Inpatient Sample data from 1995 to 2006, screening admissions with a primary diagnostic code for spinal vascular malformation. In these 11 years, 3291 patients were admitted with a diagnosis of spinal vascular malformation, with an average of 299 annual admissions with a new diagnosis of sAVM; the majority of admissions corresponded to male patients (57%) in the 45-64-year age range (36% of admissions). […] Jellema et al. analyzed all reported series with more than five patients affected by direct sAVMs, detecting there were 968 men against 210 women (ratio almost 5:1). The mean age at the time of diagnosis was found to be 55-60 years; patients under the age of 30 were rarely reported (14 patients under age 30 were found in the 1178 patients or 1%). The youngest patients reported were 22 years at the time of diagnosis. In their study was concluded that no patient under the age of 20 has ever been reported.

• #7 National trends in spinal arteriovenous malformations in: Neurosurgical Focus Volume 26 Issue 1 (2009) Journals

  https://thejns.org/focus/view/journals/neurosurg-focus/26/1/article-p1.xml

  Little has been written regarding the epidemiology of spinal AVMs. […] We report on and analyze the number of cases, type of treatment offered, length and cost of hospitalization, and patient age and sex at presentation. […] A total of 3291 patients were admitted with the diagnosis of spinal vascular malformation over the 11-year period of our study. […] On average, 299 patients were annually admitted to hospitals nationwide with the new diagnosis of spinal AVM. […] Length of hospital stay following spinal AVM admission and management was also reported. […] Over the 11-year time span, the average cost of admission and treatment increased dramatically. […] Choice of management of spinal AVMs changed ~49% of spinal AVM admissions were treated surgically. […] By 2006, only one-third of admissions (33%) were operatively managed.

• #8 Arteriovenous Malformations (AVM) | Living With Paralysis

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/arteriovenous-malformations/

  AVMs can occur in any part of the body. […] An AVM in the Central Nervous System (CNS) is a serious condition. […] An AVM in the spinal cord is designated as a spinal AVM. […] Some AVMs rebleed. […] The cause of a sAVM or other AVM is unknown. […] sAVM in the pediatric population is rarer than in adults. […] AVM is more common in men than in women. […] Occurrence of sAVM is less than 3% of the population which makes AVM a very rare condition. […] The average age for sAVM diagnosis is about 30-45 years but can occur at any time in the lifespan. […] The most common sAVM is intradural (inside the spinal cord covering) at 80%.

• #9 Arteriovenous malformation – Wikipedia

  https://en.wikipedia.org/wiki/Arteriovenous_malformation

  The estimated detection rate of AVM in the US general population is 1.4/100,000 per year. This is approximately one-fifth to one-seventh the incidence of intracranial aneurysms. An estimated 300,000 Americans have AVMs, of whom 12% (approximately 36,000) will exhibit symptoms of greatly varying severity. […] AVMs can occur in various parts of the body: brain (cerebral AV malformation), spleen, lung, kidney, spinal cord, liver, intercostal space, iris, spermatic cord, extremities arm, shoulder, etc. […] AVMs may occur in isolation or as a part of another disease (for example, Sturge-Weber syndrome or hereditary hemorrhagic telangiectasia).

• #10 Spinal arteriovenous malformations | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/spinal-arteriovenous-malformations?embed_domain=hackmd.io%2F%40yIPUAFeCSL2JsU8smR5nJQ%2Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.pngfavicon.icoradiopaedia-icon-144.pngfavicon.ico&lang=us

  Spinal arteriovenous malformations (AVMs) are characterized by arteriovenous shunting with a true nidus. They represent ~25% of spinal vascular malformations. […] Different types of spinal AVM have different ages of presentation, but overall 80% present between the age of 20 and 60 years. […] Both surgery and angioembolisation have a role in the treatment of spinal AVMs.

• #11 Spinal Arteriovenous Malformation (AVM) – Neurosurgery | UCLA Health

  https://www.uclahealth.org/medical-services/neurosurgery/conditions-treated/spinal-arteriovenous-malformation-avm

  Spinal arteriovenous malformations (AVMs) are abnormal collections of blood vessels in the spinal canal that have a direct connection between the arterial system and the venous system without intervening capillaries. AVMs account for about 4 percent of primary intraspinal masses, so the actual number of cases is very low. Eighty percent occur between ages 20 and 60. […] Spinal dural AVMs are the most common type in adults. […] The advent of magnetic resonance imaging (MRI) has increased the likelihood of identifying spinal AVM lesions.

• #12 Spinal arteriovenous malformations

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-50442021000200077

  sAVMs make up the most common vascular anomaly of the spine, with an estimated proportion of 60-80%. sAVMs account for 3-4% of all intradural spinal cord mass lesions, and dural sAVMs are the most common vascular malformation, accounting for 50-85% of all lesions. […] Lad et al. analyzed National Inpatient Sample data from 1995 to 2006, screening admissions with a primary diagnostic code for spinal vascular malformation. In these 11 years, 3291 patients were admitted with a diagnosis of spinal vascular malformation, with an average of 299 annual admissions with a new diagnosis of sAVM; the majority of admissions corresponded to male patients (57%) in the 45-64-year age range (36% of admissions). […] Jellema et al. analyzed all reported series with more than five patients affected by direct sAVMs, detecting there were 968 men against 210 women (ratio almost 5:1). The mean age at the time of diagnosis was found to be 55-60 years; patients under the age of 30 were rarely reported (14 patients under age 30 were found in the 1178 patients or 1%). The youngest patients reported were 22 years at the time of diagnosis. In their study was concluded that no patient under the age of 20 has ever been reported.

• #13 Arteriovenous Malformations (AVM) | Living With Paralysis

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/arteriovenous-malformations/

  AVMs can occur in any part of the body. […] An AVM in the Central Nervous System (CNS) is a serious condition. […] An AVM in the spinal cord is designated as a spinal AVM. […] Some AVMs rebleed. […] The cause of a sAVM or other AVM is unknown. […] sAVM in the pediatric population is rarer than in adults. […] AVM is more common in men than in women. […] Occurrence of sAVM is less than 3% of the population which makes AVM a very rare condition. […] The average age for sAVM diagnosis is about 30-45 years but can occur at any time in the lifespan. […] The most common sAVM is intradural (inside the spinal cord covering) at 80%.

• #14 Spinal arteriovenous malformations

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-50442021000200077

  sAVMs make up the most common vascular anomaly of the spine, with an estimated proportion of 60-80%. sAVMs account for 3-4% of all intradural spinal cord mass lesions, and dural sAVMs are the most common vascular malformation, accounting for 50-85% of all lesions. […] Lad et al. analyzed National Inpatient Sample data from 1995 to 2006, screening admissions with a primary diagnostic code for spinal vascular malformation. In these 11 years, 3291 patients were admitted with a diagnosis of spinal vascular malformation, with an average of 299 annual admissions with a new diagnosis of sAVM; the majority of admissions corresponded to male patients (57%) in the 45-64-year age range (36% of admissions). […] Jellema et al. analyzed all reported series with more than five patients affected by direct sAVMs, detecting there were 968 men against 210 women (ratio almost 5:1). The mean age at the time of diagnosis was found to be 55-60 years; patients under the age of 30 were rarely reported (14 patients under age 30 were found in the 1178 patients or 1%). The youngest patients reported were 22 years at the time of diagnosis. In their study was concluded that no patient under the age of 20 has ever been reported.

• #15 Spinal arteriovenous malformations

  http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1665-50442021000200077

  sAVMs make up the most common vascular anomaly of the spine, with an estimated proportion of 60-80%. sAVMs account for 3-4% of all intradural spinal cord mass lesions, and dural sAVMs are the most common vascular malformation, accounting for 50-85% of all lesions. […] Lad et al. analyzed National Inpatient Sample data from 1995 to 2006, screening admissions with a primary diagnostic code for spinal vascular malformation. In these 11 years, 3291 patients were admitted with a diagnosis of spinal vascular malformation, with an average of 299 annual admissions with a new diagnosis of sAVM; the majority of admissions corresponded to male patients (57%) in the 45-64-year age range (36% of admissions). […] Jellema et al. analyzed all reported series with more than five patients affected by direct sAVMs, detecting there were 968 men against 210 women (ratio almost 5:1). The mean age at the time of diagnosis was found to be 55-60 years; patients under the age of 30 were rarely reported (14 patients under age 30 were found in the 1178 patients or 1%). The youngest patients reported were 22 years at the time of diagnosis. In their study was concluded that no patient under the age of 20 has ever been reported.

• #16 Spinal Vascular Malformations and Treatment | Radiology Key

  https://radiologykey.com/spinal-vascular-malformations-and-treatment/

  Intramedullary AVM is the second most common spinal vascular lesion, accounting for about 20 % of spinal vascular lesions. There is slight male predominance and they commonly come to clinical attention in the second and third decade of life. […] Type III lesions constitute about 6 % of all spinal vascular malformations. They are equally located in the cervical, thoracic, and lumbar or conus medullaris regions. There is a 2:1 male to female ratio. They come to clinical attention in childhood and early adulthood. They may be multiple in as high as 19 % of patients. They may be associated with Klippel-Trenaunay and Parkes Weber syndromes.

• #17 Spinal Vascular Malformations and Treatment | Radiology Key

  https://radiologykey.com/spinal-vascular-malformations-and-treatment/

  Intramedullary AVM is the second most common spinal vascular lesion, accounting for about 20 % of spinal vascular lesions. There is slight male predominance and they commonly come to clinical attention in the second and third decade of life. […] Type III lesions constitute about 6 % of all spinal vascular malformations. They are equally located in the cervical, thoracic, and lumbar or conus medullaris regions. There is a 2:1 male to female ratio. They come to clinical attention in childhood and early adulthood. They may be multiple in as high as 19 % of patients. They may be associated with Klippel-Trenaunay and Parkes Weber syndromes.

• #18 Spinal Arteriovenous Malformation (AVM) – Neurosurgery | UCLA Health

  https://www.uclahealth.org/medical-services/neurosurgery/conditions-treated/spinal-arteriovenous-malformation-avm

  Spinal arteriovenous malformations (AVMs) are abnormal collections of blood vessels in the spinal canal that have a direct connection between the arterial system and the venous system without intervening capillaries. AVMs account for about 4 percent of primary intraspinal masses, so the actual number of cases is very low. Eighty percent occur between ages 20 and 60. […] Spinal dural AVMs are the most common type in adults. […] The advent of magnetic resonance imaging (MRI) has increased the likelihood of identifying spinal AVM lesions.

• #19 Epidemiology, clinical presentation, diagnostic evaluation, and prognosis of spinal arteriovenous malformations – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28552136/

  Spinal arteriovenous malformations (sAVM) are rare vascular pathologies whose natural history remains incompletely understood. Epidemiologically, intradural dorsal AVFs account for 80% of all sAVMs, and are characterized by low-pressure shunts located in the sleeve of the dorsal nerve root. The purpose of this chapter is to review and summarize the classification, natural history, and prognosis of sAVMs. […] Advances in diagnostic imaging, coupled with the evolution of endovascular and microsurgical techniques have led to the description of a number of classification schemes for these lesions. Treatment outcomes have been shown to differ based on classification criteria. The increased use of advanced imaging prior to surgical intervention has facilitated the treatment of AVFs. […] Definitive diagnosis and characterization have traditionally required digital subtraction angiography, which is now being supplemented with other forms of noninvasive imaging such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Successful treatment of sAVM mandates a thorough understanding of the anatomy and classification of these lesions.

• #20 Arteriovenous malformations – WikiLectures

  https://www.wikilectures.eu/w/Arteriovenous_malformations

  The incidence in the population is relatively low, newly diagnosed cases reach the value of 1-1.5 cases per 100,000 inhabitants. AVM most often manifests itself at a younger age, typically between the ages of 15 and 20. year of life. […] In the brain, AVMs are localized, AVMs are localized (86 %), of which those in the neocortex, the deeply deposited AVM’s (diencephalon, basal ganglia, capsula interna etc.) and combined AVM’s archi- and paleocortex lead in incidence. […] 80% of spinal AVMs are intramedullary or extramedullary. […] Hemorrhage from AVM is approximately 30% subarachnoid, 23 % intraparenchymal, 16% intraventricular, and 31% is a combination of these.

• #21 Arteriovenous Malformations (AVM) | Living With Paralysis

  https://www.christopherreeve.org/todays-care/living-with-paralysis/health/causes-of-paralysis/arteriovenous-malformations/

  AVMs can occur in any part of the body. […] An AVM in the Central Nervous System (CNS) is a serious condition. […] An AVM in the spinal cord is designated as a spinal AVM. […] Some AVMs rebleed. […] The cause of a sAVM or other AVM is unknown. […] sAVM in the pediatric population is rarer than in adults. […] AVM is more common in men than in women. […] Occurrence of sAVM is less than 3% of the population which makes AVM a very rare condition. […] The average age for sAVM diagnosis is about 30-45 years but can occur at any time in the lifespan. […] The most common sAVM is intradural (inside the spinal cord covering) at 80%.

• #22 Epidemiology, clinical presentation, diagnostic evaluation, and prognosis of spinal arteriovenous malformations – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28552136/

  Spinal arteriovenous malformations (sAVM) are rare vascular pathologies whose natural history remains incompletely understood. Epidemiologically, intradural dorsal AVFs account for 80% of all sAVMs, and are characterized by low-pressure shunts located in the sleeve of the dorsal nerve root. The purpose of this chapter is to review and summarize the classification, natural history, and prognosis of sAVMs. […] Advances in diagnostic imaging, coupled with the evolution of endovascular and microsurgical techniques have led to the description of a number of classification schemes for these lesions. Treatment outcomes have been shown to differ based on classification criteria. The increased use of advanced imaging prior to surgical intervention has facilitated the treatment of AVFs. […] Definitive diagnosis and characterization have traditionally required digital subtraction angiography, which is now being supplemented with other forms of noninvasive imaging such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Successful treatment of sAVM mandates a thorough understanding of the anatomy and classification of these lesions.

• #23 Conus medullary arteriovenous malformation mimicking intramedullary tumor: a case report | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00553-y

  The clinical course of AVM and ependymoma are similar and cannot be differentiated. […] Intramedullary AVM lesion has an unremitting neurological worsening, with 50% of all patients being severely disabled in three years, and only less than 10% could walk without assistance. […] A thorough examination is essential in differentiating spinal AVM from other lesions and planning a suitable therapeutic option. […] The gold standard examination for spinal AVM is Digital Subtraction Angiography (DSA). […] Long-term surveillance is also essential in determining whether or not there is a regrowth of the lesion, which could affect neurological function.

• #24 Spinal Arteriovenous Malformation (AVM) – Neurosurgery | UCLA Health

  https://www.uclahealth.org/medical-services/neurosurgery/conditions-treated/spinal-arteriovenous-malformation-avm

  Spinal arteriovenous malformations (AVMs) are abnormal collections of blood vessels in the spinal canal that have a direct connection between the arterial system and the venous system without intervening capillaries. AVMs account for about 4 percent of primary intraspinal masses, so the actual number of cases is very low. Eighty percent occur between ages 20 and 60. […] Spinal dural AVMs are the most common type in adults. […] The advent of magnetic resonance imaging (MRI) has increased the likelihood of identifying spinal AVM lesions.

• #25 MR Angiography Spinal Canal

  https://member.myhealthtoolkitex.com/web/public/brands/medicalpolicyih/external-policies/mr-angiography-spinal-canal

  Spinal arteriovenous malformations are comprised of snarled tangles of arteries and veins that affect the spinal cord. They are fed by spinal cord arteries and drained by spinal cord veins. Spinal dural arteriovenous fistulas are the most encountered vascular malformation of the spinal cord and are a treatable cause of progressive paraparesis. Magnetic resonance angiography (MRA) can record the pattern and velocity of blood flow through vascular lesions as well as the flow of cerebrospinal fluid throughout the spinal cord. MRA can define the vascular malformation and may assist in determining treatment. […] For the evaluation of spinal arteriovenous malformation (AVM) […] All other uses of this technology are investigational and/or unproven and are therefore considered NOT MEDICALLY NECESSARY.

• #26 Conus medullary arteriovenous malformation mimicking intramedullary tumor: a case report | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00553-y

  The clinical course of AVM and ependymoma are similar and cannot be differentiated. […] Intramedullary AVM lesion has an unremitting neurological worsening, with 50% of all patients being severely disabled in three years, and only less than 10% could walk without assistance. […] A thorough examination is essential in differentiating spinal AVM from other lesions and planning a suitable therapeutic option. […] The gold standard examination for spinal AVM is Digital Subtraction Angiography (DSA). […] Long-term surveillance is also essential in determining whether or not there is a regrowth of the lesion, which could affect neurological function.

• #27 Spinal Arteriovenous Malformation: Case Report and Review of the Literature – PMC Lock

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7752798/

  Spinal arteriovenous malformations (AVMs) are a rare form of spinal blood vessel defect that results in vessel engorgement leading to clinical signs secondary to mass effect and ischemia. […] Annually, around 300 cases of spinal AVMs present in hospitals and require treatment. […] While the risk of recurrence in adult AVM patients is low, a long-term follow-up to monitor recurrence is important. This is especially true in patients under the age of 18 as previous case reports/series cited a recurrence rate between 5.5% and 17.5% with the recurrence time ranging from one to five years after complete resection. […] Spinal AVMs are a heterogeneous group of vascular lesions with a clinical presentation that is dependent on the affected spinal segment as well as the extensiveness of the malformation.

• #28 Spinal Vascular Malformations and Treatment | SpringerLink

  https://link.springer.com/10.1007/978-1-4614-9212-2_45-1

  Spinal vascular malformations are rare, but a diverse group of neurovascular pathologies including arteriovenous malformations (AVMs), cavernous malformations, and dural arteriovenous fistulas (dAVFs) that occur due to developmental derangement of the vascular system. […] Most spinal vascular malformations come to clinical attention by nonspecific symptomatology that may be acute, subacute, or chronic. […] Early diagnosis and timely management in symptomatic patients can result in improvement or stabilization of clinical condition. […] Early diagnosis and prompt treatment are essential to alter the natural course and result in clinical improvement. […] Venous congestion is a major cause of neurological deterioration in spinal arteriovenous malformations.

• #29 Endovascular treatment of spinal AVM: report of two cases with transvenous approach in combination with retrograde pressure cooker technique | springermedizin.de

  https://www.springermedizin.de/endovascular-treatment-of-spinal-avm-report-of-two-cases-with-tr/24085822

  Spinal arteriovenous malformations (AVMs) are rare conditions that become clinically significant either by bleeding or progressive neurological symptoms. In a systematic review, the annual bleeding rate of glomus type II AVMs was 4%, increasing to 10% after the first hemorrhage. Complete obliteration rates have been reported with 78% for surgery and 33% for endovascular treatment. Long-term clinical worsening was noted, with 12% for surgical and 13% for endovascular treated patients. Since no large trials are available, the reports about treatment are limited to small case series with heterogeneous populations. Endovascular treatment of spinal AVMs is a non-standardized approach to treating this rare disease. So far, reported rates of a complete cure are low, and transarterial embolization may be hazardous or limited by access route. These are the first reported cases of transvenous treatments of spinal AVMs with liquid embolics in pressure cooker technique. The transvenous approach to AVMs principally offers three particular advantages: 1. Endovascular treatment of the lesion gets feasible also when there is no suitable arterial access. 2. The risk of arterial ischemia might be lower since no direct arterial embolization takes place. 3. The treatment of the vein allows a definite cure of the lesion, whereas arterial embolization often results only in partial occlusion of shunts and the primary veins. Transvenous treatment of spinal AVMs in combination with retrograde pressure cooker technique was feasible and effective. The main limitation is the accessibility of the venous anatomy. In case of mild tortuosity of the draining veins, this technique can be considered and potentially offers a higher occlusion rate and fewer ischemic or toxic complications.

• #30 Epidemiology of Arteriovenous Malformations | East Bay Brain & Spine

  https://www.eastbaybrainandspine.com/conditions/vascular/arteriovenous-malformations/epidemiology-arteriovenous-malformations/

  Arteriovenous malformations (AVMs) are relatively rare and occur in less than 1% of the general population. […] The incidence of detection is estimated to be around 1 in every 100,000 people per year. The overall prevalence is believed to be around 18 per 100,000 individuals. […] AVMs can be found at any age, but symptoms usually first appear between the ages of 10 and 40. […] Both sexes are equally affected by AVMs. However, hemorrhage due to AVM rupture is reportedly more common in females. […] The annual risk of hemorrhage in patients with untreated AVMs is estimated to be around 2-4% per year. […] Hemorrhage is the most serious complication of AVMs and can result in significant neurological deficits or death. The mortality rate after an AVM rupture is estimated to be around 10-15%, and morbidity (disability) rates are much higher. […] The epidemiology of AVMs underscores the importance of their early detection and appropriate management. With proper treatment, the risks of hemorrhage and the associated neurological damage can be significantly reduced.

• #31 Epidemiology of Arteriovenous Malformations | East Bay Brain & Spine

  https://www.eastbaybrainandspine.com/conditions/vascular/arteriovenous-malformations/epidemiology-arteriovenous-malformations/

  Arteriovenous malformations (AVMs) are relatively rare and occur in less than 1% of the general population. […] The incidence of detection is estimated to be around 1 in every 100,000 people per year. The overall prevalence is believed to be around 18 per 100,000 individuals. […] AVMs can be found at any age, but symptoms usually first appear between the ages of 10 and 40. […] Both sexes are equally affected by AVMs. However, hemorrhage due to AVM rupture is reportedly more common in females. […] The annual risk of hemorrhage in patients with untreated AVMs is estimated to be around 2-4% per year. […] Hemorrhage is the most serious complication of AVMs and can result in significant neurological deficits or death. The mortality rate after an AVM rupture is estimated to be around 10-15%, and morbidity (disability) rates are much higher. […] The epidemiology of AVMs underscores the importance of their early detection and appropriate management. With proper treatment, the risks of hemorrhage and the associated neurological damage can be significantly reduced.

• #32 Conus medullary arteriovenous malformation mimicking intramedullary tumor: a case report | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00553-y

  Spinal arteriovenous malformation (AVM) is often missed because of overlapping symptoms with other pathology and ambiguous imaging. […] Spinal arteriovenous malformation (AVM) is a type of vascular malformation of the spine composed of nidus with draining vein and feeding artery, accounting for 34% of all intradural spinal cord tumours. […] Despite advances in neuroimaging technology, vascular lesion diagnosis is often missed, because the symptoms usually overlap with more frequent cases of myelopathy, such as neoplasms and other spinal degenerative diseases. […] If left untreated, spinal AVM could cause significant and progressive neurological disability in a short time. […] Because of the similarity in epidemiology, symptoms, clinical progression, and imaging, suspicion of spinal AVM should remain.

• #33 Conus medullary arteriovenous malformation mimicking intramedullary tumor: a case report | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Full Text

  https://ejnpn.springeropen.com/articles/10.1186/s41983-022-00553-y

  The clinical course of AVM and ependymoma are similar and cannot be differentiated. […] Intramedullary AVM lesion has an unremitting neurological worsening, with 50% of all patients being severely disabled in three years, and only less than 10% could walk without assistance. […] A thorough examination is essential in differentiating spinal AVM from other lesions and planning a suitable therapeutic option. […] The gold standard examination for spinal AVM is Digital Subtraction Angiography (DSA). […] Long-term surveillance is also essential in determining whether or not there is a regrowth of the lesion, which could affect neurological function.

• #34 National trends in spinal arteriovenous malformations in: Neurosurgical Focus Volume 26 Issue 1 (2009) Journals

  https://thejns.org/focus/view/journals/neurosurg-focus/26/1/article-p1.xml

  Spinal arteriovenous malformations (AVMs) are rare and understudied vascular lesions that cause neurological insult by mass effect, venous obstruction, and vascular steal. Current management options include open microsurgery, endovascular embolization, and stereotactic radiosurgery. […] Trends in procedural management, hospital course, and epidemiology of spinal AVMs are investigated. […] Annually, an average of 300 patients presented with spinal AVMs requiring hospital treatment. […] The average length of hospital stay for this treatment has declined from more than 9 days in 1995 to 6 days in 2006. […] However, the average cost of a hospital stay has increased from $30,000 to nearly $70,000. […] Whereas one-half of spinal AVMs were treated operatively in 1995, one-third were managed operatively in 2006.

• #35 National trends in spinal arteriovenous malformations in: Neurosurgical Focus Volume 26 Issue 1 (2009) Journals

  https://thejns.org/focus/view/journals/neurosurg-focus/26/1/article-p1.xml

  Spinal arteriovenous malformations (AVMs) are rare and understudied vascular lesions that cause neurological insult by mass effect, venous obstruction, and vascular steal. Current management options include open microsurgery, endovascular embolization, and stereotactic radiosurgery. […] Trends in procedural management, hospital course, and epidemiology of spinal AVMs are investigated. […] Annually, an average of 300 patients presented with spinal AVMs requiring hospital treatment. […] The average length of hospital stay for this treatment has declined from more than 9 days in 1995 to 6 days in 2006. […] However, the average cost of a hospital stay has increased from $30,000 to nearly $70,000. […] Whereas one-half of spinal AVMs were treated operatively in 1995, one-third were managed operatively in 2006.

• #36 National trends in spinal arteriovenous malformations in: Neurosurgical Focus Volume 26 Issue 1 (2009) Journals

  https://thejns.org/focus/view/journals/neurosurg-focus/26/1/article-p1.xml

  This interval of time saw advances in endovascular techniques and in the use of stereotactic radiosurgery to complement or supercede open surgery. […] Trends are reported not only for the type of treatment selected, but also for LOS and total hospital charges, as well as for age and sex classification, insurance status, and type of hospital in which treatment occurred. […] The NIS database provides a valuable opportunity for examining trends in the frequency of procedures and population characteristics for a number of different diagnoses. […] This type of administrative database also has some inherent limitations. […] Nonetheless, this database provides us with useful information regarding trends in the management of spinal AVMs on a national level and provides fodder for discussion of the pathology, natural history, and changing management paradigm of these understudied lesions.

• #37 Endovascular treatment of spinal AVM: report of two cases with transvenous approach in combination with retrograde pressure cooker technique | springermedizin.de

  https://www.springermedizin.de/endovascular-treatment-of-spinal-avm-report-of-two-cases-with-tr/24085822

  Spinal arteriovenous malformations (AVMs) are rare conditions that become clinically significant either by bleeding or progressive neurological symptoms. In a systematic review, the annual bleeding rate of glomus type II AVMs was 4%, increasing to 10% after the first hemorrhage. Complete obliteration rates have been reported with 78% for surgery and 33% for endovascular treatment. Long-term clinical worsening was noted, with 12% for surgical and 13% for endovascular treated patients. Since no large trials are available, the reports about treatment are limited to small case series with heterogeneous populations. Endovascular treatment of spinal AVMs is a non-standardized approach to treating this rare disease. So far, reported rates of a complete cure are low, and transarterial embolization may be hazardous or limited by access route. These are the first reported cases of transvenous treatments of spinal AVMs with liquid embolics in pressure cooker technique. The transvenous approach to AVMs principally offers three particular advantages: 1. Endovascular treatment of the lesion gets feasible also when there is no suitable arterial access. 2. The risk of arterial ischemia might be lower since no direct arterial embolization takes place. 3. The treatment of the vein allows a definite cure of the lesion, whereas arterial embolization often results only in partial occlusion of shunts and the primary veins. Transvenous treatment of spinal AVMs in combination with retrograde pressure cooker technique was feasible and effective. The main limitation is the accessibility of the venous anatomy. In case of mild tortuosity of the draining veins, this technique can be considered and potentially offers a higher occlusion rate and fewer ischemic or toxic complications.

• #38 National trends in spinal arteriovenous malformations in: Neurosurgical Focus Volume 26 Issue 1 (2009) Journals

  https://thejns.org/focus/view/journals/neurosurg-focus/26/1/article-p1.xml

  Spinal arteriovenous malformations (AVMs) are rare and understudied vascular lesions that cause neurological insult by mass effect, venous obstruction, and vascular steal. Current management options include open microsurgery, endovascular embolization, and stereotactic radiosurgery. […] Trends in procedural management, hospital course, and epidemiology of spinal AVMs are investigated. […] Annually, an average of 300 patients presented with spinal AVMs requiring hospital treatment. […] The average length of hospital stay for this treatment has declined from more than 9 days in 1995 to 6 days in 2006. […] However, the average cost of a hospital stay has increased from $30,000 to nearly $70,000. […] Whereas one-half of spinal AVMs were treated operatively in 1995, one-third were managed operatively in 2006.

• #39

  https://scholars.duke.edu/publication/731190

  OBJECT: Spinal arteriovenous malformations (AVMs) are rare and understudied vascular lesions that cause neurological insult by mass effect, venous obstruction, and vascular steal. […] Trends in procedural management, hospital course, and epidemiology of spinal AVMs are investigated. […] Annually, an average of 300 patients presented with spinal AVMs requiring hospital treatment. […] The average length of hospital stay for this treatment has declined from more than 9 days in 1995 to 6 days in 2006. […] However, the average cost of a hospital stay has increased from $30,000 to nearly $70,000. […] Whereas one-half of spinal AVMs were treated operatively in 1995, one-third were managed operatively in 2006. […] Spinal AVMs are being increasingly treated by endovascular, radiosurgical, or combined means.

• #40 Epidemiology of Arteriovenous Malformations | East Bay Brain & Spine

  https://www.eastbaybrainandspine.com/conditions/vascular/arteriovenous-malformations/epidemiology-arteriovenous-malformations/

  Arteriovenous malformations (AVMs) are relatively rare and occur in less than 1% of the general population. […] The incidence of detection is estimated to be around 1 in every 100,000 people per year. The overall prevalence is believed to be around 18 per 100,000 individuals. […] AVMs can be found at any age, but symptoms usually first appear between the ages of 10 and 40. […] Both sexes are equally affected by AVMs. However, hemorrhage due to AVM rupture is reportedly more common in females. […] The annual risk of hemorrhage in patients with untreated AVMs is estimated to be around 2-4% per year. […] Hemorrhage is the most serious complication of AVMs and can result in significant neurological deficits or death. The mortality rate after an AVM rupture is estimated to be around 10-15%, and morbidity (disability) rates are much higher. […] The epidemiology of AVMs underscores the importance of their early detection and appropriate management. With proper treatment, the risks of hemorrhage and the associated neurological damage can be significantly reduced.

• #41 Spinal Arteriovenous Malformation: Case Report and Review of the Literature – PMC Lock

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7752798/

  Spinal arteriovenous malformations (AVMs) are a rare form of spinal blood vessel defect that results in vessel engorgement leading to clinical signs secondary to mass effect and ischemia. […] Annually, around 300 cases of spinal AVMs present in hospitals and require treatment. […] While the risk of recurrence in adult AVM patients is low, a long-term follow-up to monitor recurrence is important. This is especially true in patients under the age of 18 as previous case reports/series cited a recurrence rate between 5.5% and 17.5% with the recurrence time ranging from one to five years after complete resection. […] Spinal AVMs are a heterogeneous group of vascular lesions with a clinical presentation that is dependent on the affected spinal segment as well as the extensiveness of the malformation.

• #42 Epidemiology, clinical presentation, diagnostic evaluation, and prognosis of spinal arteriovenous malformations – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28552136/

  Spinal arteriovenous malformations (sAVM) are rare vascular pathologies whose natural history remains incompletely understood. Epidemiologically, intradural dorsal AVFs account for 80% of all sAVMs, and are characterized by low-pressure shunts located in the sleeve of the dorsal nerve root. The purpose of this chapter is to review and summarize the classification, natural history, and prognosis of sAVMs. […] Advances in diagnostic imaging, coupled with the evolution of endovascular and microsurgical techniques have led to the description of a number of classification schemes for these lesions. Treatment outcomes have been shown to differ based on classification criteria. The increased use of advanced imaging prior to surgical intervention has facilitated the treatment of AVFs. […] Definitive diagnosis and characterization have traditionally required digital subtraction angiography, which is now being supplemented with other forms of noninvasive imaging such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Successful treatment of sAVM mandates a thorough understanding of the anatomy and classification of these lesions.

• #43 Epidemiology, clinical presentation, diagnostic evaluation, and prognosis of spinal arteriovenous malformations – PubMed

  https://pubmed.ncbi.nlm.nih.gov/28552136/

  Spinal arteriovenous malformations (sAVM) are rare vascular pathologies whose natural history remains incompletely understood. Epidemiologically, intradural dorsal AVFs account for 80% of all sAVMs, and are characterized by low-pressure shunts located in the sleeve of the dorsal nerve root. The purpose of this chapter is to review and summarize the classification, natural history, and prognosis of sAVMs. […] Advances in diagnostic imaging, coupled with the evolution of endovascular and microsurgical techniques have led to the description of a number of classification schemes for these lesions. Treatment outcomes have been shown to differ based on classification criteria. The increased use of advanced imaging prior to surgical intervention has facilitated the treatment of AVFs. […] Definitive diagnosis and characterization have traditionally required digital subtraction angiography, which is now being supplemented with other forms of noninvasive imaging such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Successful treatment of sAVM mandates a thorough understanding of the anatomy and classification of these lesions.

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