C41 Intradural ventral spinal arteriovenous fistula: a pediatric case

<h3>Introduction</h3> Intradural ventral spinal arteriovenous fistulas (IV-sAVF) are vascular lesions originating directly from the anterior spinal artery with a direct fistula to an enlarged venous network. They occur more commonly in the 3rd decade of life, seldom in the cervical region. Here, we present the case of a female child treated for an IV-sAVF located at the cervicothoracic junction. <h3>Case Description</h3> A 15-month-old female presented with a 7-month history of progressive tetraparesis. Spinal MRI revealed a ‘flow void’ at the cervicothoracic junction associated with spinal compression. Spinal angiography found an ectatic left perimedullary vein spanning from C5 to T2, measuring 27x43 mm. It was supplied by the anterior spinal arteries at the C7-T1 projection and drainage occurred via a radicular vein at the same level. Endovascular embolization occured through a 5F right femoral artery access. Access to the left intercostobronchial artery was achieved with a 5F HeadHunter catheter, followed by the placement of an Echelon-10 microcatheter above the fistulous point, where a coil was placed. Embolization was completed with a tissue adhesive solution (Histoacryl®). Subsequent control angiography demonstrated fistular occlusion. Seven months post-treatment, the patient exhibited progressive improvement, currently being able to stand straight and manipulate objects effectively with her hands. <h3>Conclusions</h3> This report provides unique insights due to the rarity of the condition in pediatric patients and its elegant and successful treatment with one coil and glue. <h3>Conflict of Interest</h3> No