Article Figures & Data
Figures
- FIG 1.
Left T9 intercostal artery angiogram in anteroposterior view shows the extension of the anterior spinal artery (arrows) traveling caudally to form an AVF at the L2 level (oblique arrow). The ascending draining vein shows a characteristic wavy pattern (arrowheads). Note the change in the course and caliber of the ASA at the conus medullaris apex (large arrow), suggesting a change of the feeding artery to a radicular artery. Reprinted with permission from Figure 2c in Tanioka S, Toma N, Sakaida H, et al. A case of AVF of the cauda equina fed by the proximal radicular artery: anatomical features and treatment precautions. Eur Spine J 2018;27(suppl 3):281–86.
- FIG 2.
A, Angiogram of the left L1 lumbar artery in anteroposterior projection demonstrates a filum terminale AVF at the L4 level. The fistula (oblique arrow) is supplied by the caudal extension of the anterior spinal artery, which is the artery of the filum, and drained by the vein of the filum. The ASA does not change its course or caliber at the conus medullaris and maintains its robust caliber down to the fistula site. Note the parallel feeder and drainer pattern. B, Serial thin-section gadolinium enhanced T1WI (left column) and T2WI (right column) arranged in caudal (upper) to cranial (lower) order show the draining vein (arrows) merging with the spinal cord at the apex of the edematous conus medullaris (arrowhead). This finding suggests that this is the vein of FT.
- FIG 3.
A, Unsubtracted (left) and subtracted (right) angiograms of the right internal iliac artery. A radicular artery (large arrows) originating from the right S1 lateral sacral artery forms a fistula (oblique arrow) at the L4 level. Note a second small feeder contributing to the fistula (small arrows). The straight ascending draining vein (arrowheads) opens into the perimedullary vein at the L1 level (small arrowhead), demonstrated by the opacification of superficial pial veins (dashed arrows). This finding suggests that the draining vein is a radicular vein. The ASA had no contribution to the fistula (not shown). B, A coexisting L1 level perimedullary AVF supplied from the left L2 radiculopial artery (arrows). An aneurysm (arrowhead) is seen at the fistulous site (small arrow). Note the faint opacification of the right S1 lateral sacral artery, identical to that seen in A, supplying the L4 level fistula (dashed arrows). Note the descending, then ascending draining vein that is separate from the right S1 radicular AVF. C, Serial thin-section gadolinium-enhanced T1WI (left column) and T2WI (right column) arranged in caudal (upper) to cranial (lower) order show the draining vein (arrows) is off the cord at the apex of the conus medullaris (arrowhead). The draining vein eventually merges with the spinal cord at a higher level (large horizontal arrow). This finding suggests that the draining vein is a radicular vein.
- FIG 4.
A, Angiogram of the left T11 intercostal artery in anteroposterior view demonstrates a posterior spinal artery supplying the anterior spinal artery (arrows) via the vasa corona. The ASA extends caudally to form a fistula at the L3 level (oblique arrow). The ascending draining vein shows a characteristic wavy pattern (arrowheads). Note the change in course and caliber of the descending ASA at the apex of the conus medullaris, suggesting a switch in the ASA to a radicular artery (large horizontal arrow). B, Medial sacral artery angiogram in anteroposterior view demonstrates anastomotic opacification of the radicular artery (arrows) from the left S1 lateral sacral artery supplying the L3 level AVF. The same draining vein seen in A is detected in this study (arrowheads). The L3 AVF in this patient has a dual supply from the ASA and an S1 radicular artery. C, Serial thin-section gadolinium-enhanced T1WI (left column) and T2WI (right column) arranged in caudal (upper) to cranial (lower) order show the draining vein (arrows) is off the cord at the apex of the conus medullaris (arrowhead). The draining vein eventually merges with the spinal cord at the L1 level (large horizontal arrow). This finding suggests that the draining vein is a radicular vein.
