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Child's Nervous System

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01-02-2020 | Magnetic Resonance Imaging | Original Article

The role of spinal angiography in the evaluation and treatment of pediatric spinal vascular pathology: a case series and systematic review

Authors: Eric Goethe, Melissa A. LoPresti, Peter Kan, Sandi K. Lam

Published in: Child's Nervous System | Issue 2/2020

Abstract

Object

While it has been extensively studied in adults, the role of spinal angiography in children with suspected spinal vascular malformations is not fully characterized. With special implications regarding technique, radiation dose, and pathology, we sought to review our single-center experience with pediatric spinal vascular pathology and use a systematic review of the literature to further identify its role in pediatrics.

Methods

A retrospective chart review was conducted under IRB approval for all patients age 0–18 years old who underwent spinal angiography at our institution between 2007 and 2018 for concern for spinal vascular pathology. A simultaneous systematic review was conducted via dedicated search terms in two distinct databases and reviewed to identify all studies referring to spinal angiography or angiograms in pediatric patients.

Results

Six patients were included. Three patients (50%) had vascular malformations confirmed on diagnostic angiography and underwent subsequent endovascular treatment. Two patients (33.3%), one with hematomyelia and one with spinal cord infarction, had negative diagnostic angiograms. One patient (16.7%) had a spinal tumor and underwent angiography for further evaluation preoperatively. Spinal angiography was used to aid in diagnosis, preoperative planning, and treatment in these cases. It was demonstrated to be safe in this patient population, with no untoward events, minimal radiation dose, and possible therapeutic applications in select cases. The systematic review identified 11 studies regarding pediatric spinal angiography. These ranged from single case reports to case series of up to 38 patients and highlighted the role of spinal angiography in diagnosis, endovascular treatment, preoperative planning, and postoperative follow-up.

Conclusions

Spinal angiography may be used in a variety of scenarios to better understand the architecture of vascular spinal lesions and facilitate endovascular intervention. While its application in both adult and pediatric pathology is limited to select cases, spinal angiography remains a key diagnostic procedure when approaching vascular lesions or tumors of the spine, assessing for etiology of spinal cord infarcts, and in the evaluation of unexplained hemorrhage in the spinal canal.

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Title: The role of spinal angiography in the evaluation and treatment of pediatric spinal vascular pathology: a case series and systematic review
Authors: Eric Goethe
Melissa A. LoPresti
Peter Kan
Sandi K. Lam
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Angiography
Arteriovenous Fistula
Spinal Tumor
Pathology
Pediatrics
Arteriovenous Fistula
Arteriovenous Malformation
Published in: Child's Nervous System / Issue 2/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04329-3

ACC 2024 Congress

Springer Medicine

The role of spinal angiography in the evaluation and treatment of pediatric spinal vascular pathology: a case series and systematic review

Abstract

Object

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Object

Methods

Results

Conclusions

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