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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:69-73, January 2004
© 2004 American Society of Neuroradiology

Case Report
INTERVENTIONAL

Spinal Osseous Epidural Arteriovenous Fistula with Multiple Small Arterial Feeders Converging to a Round Fistular Nidus as a Target of Venous Approach

Dae Chul Suh^a, Choong Gon Choi^a, Kyu Bo Sung^a, Kwang-Kuk Kim^b and Seung Chul Rhim^c

^a Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
^b Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
^c Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Address correspondence to Dae Chul Suh, MD, Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388–1 Poongnap Dong, Songpa-Gu, Seoul, 138–736, Korea

Summary: We present two patients with spinal epidural arteriovenous fistulas involving the vertebral body recruiting dural and osseous branches as feeders. The fistulas, forming a round venous sac into which the multiple arterial feeders converge, were located near the round bony defect of the vertebral body, suggesting the osseous component of this vascular lesion. Transvenous coil embolization of the round venous sac results in near-total obliteration of the lesion, leading to symptomatic improvement.