Treatment of Slow-Flow (Type I) Perimedullary Spinal Arteriovenous Fistulas with Special Reference to Embolization

Summary: Embolization of type I perimedullary spinal ar-teriovenous fistulas (AVFs) can be difficult, because of tortuosity and the small diameter of the feeder and distal location of the fistula site. The 1.5F flow-directed catheter in conjunction with a hydrophilic guidewire has been used in fistula embolization with cyanoacrylate glue for spinal vascular malformations at our institution. This combina-tion has improved our success rate in achieving superse-lective catheterization of the fistula. Thus, 4 of 5 patients with type I perimedullary AVFs could be cured with this technique. Like type II and type III perimedullary AVFs, the endovascular approach may also be the first line of treatment in type I perimedullary spinal AVF. Perimedullary arteriovenous fistulas (AVFs) of the spinal cord are rare vascular malformations. This typ