Biomaterial Database

Classification and surgical management of spinal arteriovenous lesions: arteriovenous fistulae and arteriovenous malformations. 2006

Louis J Kim, and Robert F Spetzler

Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.

OBJECTIVE Preexisting spinal arteriovenous malformation nomenclature can be confusing. The aim of this article is to present a modified classification system for spinal arteriovenous lesions and to discuss its implications for microsurgical strategies. METHODS Based on the literature review of prior classifications as well as on the experience of the senior author (RFS), the authors delineate an anatomically and pathophysiologically based classification to facilitate the description and treatment of these uncommon entities. RESULTS Spinal arteriovenous lesions are composed of arteriovenous fistulae and malformations. These lesions are classified as extradural, extradural-intradural, or intradural. Intradural lesions are characterized further as ventral or dorsal fistulae or as intramedullary lesions. Intramedullary lesions are characterized as compact or diffuse. A new category, conus medullaris arteriovenous malformations, is described as a distinct entity. CONCLUSIONS This updated classification system eliminates confusion related to older nomenclature and is based on the anatomical and pathophysiological features of these lesions. When treating these lesions, the neurovascular team must collaborate closely with their microsurgical and endovascular colleagues. Finally, treatment should be individualized, depending on lesional angioarchitecture and the patient's clinical status.

UI	MeSH Term	Description	Entries
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001164	Arteriovenous Fistula	An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.	Aneurysm, Arteriovenous,Arteriovenous Aneurysm,Arteriovenous Fistulas,Fistula, Arteriovenous,Fistulas, Arteriovenous
D001165	Arteriovenous Malformations	Abnormal formation of blood vessels that shunt arterial blood directly into veins without passing through the CAPILLARIES. They usually are crooked, dilated, and with thick vessel walls. A common type is the congenital arteriovenous fistula. The lack of blood flow and oxygen in the capillaries can lead to tissue damage in the affected areas.	Arteriovenous Malformation,Malformation, Arteriovenous,Malformations, Arteriovenous
D013116	Spinal Cord	A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.	Coccygeal Cord,Conus Medullaris,Conus Terminalis,Lumbar Cord,Medulla Spinalis,Myelon,Sacral Cord,Thoracic Cord,Coccygeal Cords,Conus Medullari,Conus Terminali,Cord, Coccygeal,Cord, Lumbar,Cord, Sacral,Cord, Spinal,Cord, Thoracic,Cords, Coccygeal,Cords, Lumbar,Cords, Sacral,Cords, Spinal,Cords, Thoracic,Lumbar Cords,Medulla Spinali,Medullari, Conus,Medullaris, Conus,Myelons,Sacral Cords,Spinal Cords,Spinali, Medulla,Spinalis, Medulla,Terminali, Conus,Terminalis, Conus,Thoracic Cords
D014656	Vascular Surgical Procedures	Operative procedures for the treatment of vascular disorders.	Vascular Surgery,Procedure, Vascular Surgical,Procedures, Vascular Surgical,Surgical Procedure, Vascular,Surgical Procedures, Vascular,Vascular Surgical Procedure,Surgeries, Vascular,Surgery, Vascular,Vascular Surgeries
D017410	Practice Guidelines as Topic	Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.	Clinical Guidelines as Topic,Best Practices,Best Practice
D019635	Neurosurgical Procedures	Surgery performed on the nervous system or its parts.	Procedures, Neurosurgical,Surgical Procedures, Neurologic,Neurologic Surgical Procedure,Neurologic Surgical Procedures,Neurosurgical Procedure,Procedure, Neurologic Surgical,Procedure, Neurosurgical,Procedures, Neurologic Surgical,Surgical Procedure, Neurologic