January 2009: Spinal Vascular Malformations

Spinal Vascular Malformations

Dr. Edward Oldfield and Dr. David Piepgras discuss spinal extradural arteriovenous malformations.

One Response to “January 2009: Spinal Vascular Malformations”

  1. Christian Says:

    The goal of brain AVM tentamert is to protect the patient from a hemorrhagic event, neurological deficits and seizures and in the pediatric population to assure a normal psycho-motor development. Complete morphological cure of an AVM cannot always be achieved if these objectives are to be respected. This is particularly evident in children in whom a rapid anatomical (and not always clinical) cure has an elevated rate of morbidity and mortality, with some clinical consequences quantifiable only later in life. Partial targeted tentamert is, in my opinion, an acceptable alternative in the management of high risk AVMs (particularly large ones and/or those in eloquent locations). Planning for an endovascular intervention involves a methodological analysis of the lesion and of the patient’s clinical conditions, setting up short and long term goals and a careful evaluation of the risks of the endovascular approach alone or combined, if necessary, with surgery and/or radiotherapy. Additionally, there are probably some operator dependent variants during the procedures, but like in other surgical specialties our results need to be comparable and even standardized in order to be believable. The results of an intervention should not be related to the “good luck” of the operator (like W. Jan Van Rooij previously states) but with a pre-established strategy and the percentage of complications and eventual patient outcome that we, the neuroradiology community, are willing to accept as ethical in our practices and training programs.

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