Incidence and clinical characteristics of spinal arteriovenous shunts: hospital-based surveillance in Okayama, Japan
| Autor: | Masafumi Hiramatsu, Koji Tokunaga, Etsuji Suzuki, Yu Takahashi, Satoshi Murai, Ryota Ishibashi, Shunji Matsubara, Yoko Yamaoka, Isao Date, Masaki Chin, Yuko Miyazaki, Hiroki Takai, Jun Haruma, Takao Yasuhara, Masaaki Uno, Tomohito Hishikawa, Kazuhiko Nishi, Yuji Takasugi, Kenji Sugiu |
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| Rok vydání: | 2022 |
| Předmět: |
Central Nervous System Vascular Malformations
Epidural Space Male medicine.medical_specialty business.industry Vascular disease Incidence Incidence (epidemiology) Arteriovenous fistula Arteriovenous malformation General Medicine Hospital based medicine.disease Spinal cord Magnetic Resonance Imaging Hospitals Surgery Spinal epidural medicine.anatomical_structure Japan Spinal Cord Epidemiology medicine Humans business |
| Zdroj: | Journal of Neurosurgery: Spine. 36:670-677 |
| ISSN: | 1547-5654 |
| DOI: | 10.3171/2021.7.spine21233 |
| Popis: | OBJECTIVE There have been no accurate surveillance data regarding the incidence rate of spinal arteriovenous shunts (SAVSs). Here, the authors investigate the epidemiology and clinical characteristics of SAVSs. METHODS The authors conducted multicenter hospital-based surveillance as an inventory survey at 8 core hospitals in Okayama Prefecture between April 1, 2009, and March 31, 2019. Consecutive patients who lived in Okayama and were diagnosed with SAVSs on angiographic studies were enrolled. The clinical characteristics and the incidence rates of each form of SAVS and the differences between SAVSs at different spinal levels were analyzed. RESULTS The authors identified a total of 45 patients with SAVSs, including 2 cases of spinal arteriovenous malformation, 5 cases of perimedullary arteriovenous fistula (AVF), 31 cases of spinal dural AVF (SDAVF), and 7 cases of spinal epidural AVF (SEAVF). The crude incidence rate was 0.234 per 100,000 person-years for all SAVSs including those at the craniocervical junction (CCJ) level. The incidence rate of SDAVF and SEAVF combined increased with advancing age in men only. In a comparative analysis between upper and lower spinal SDAVF/SEAVF, hemorrhage occurred in 7/14 cases (50%) at the CCJ/cervical level and in 0/24 cases (0%) at the thoracolumbar level (p = 0.0003). Venous congestion appeared in 1/14 cases (7%) at the CCJ/cervical level and in 23/24 cases (96%) at the thoracolumbar level (p < 0.0001). CONCLUSIONS The authors reported detailed incidence rates of SAVSs in Japan. There were some differences in clinical characteristics of SAVSs in the upper spinal levels and those in the lower spinal levels. |
| Databáze: | OpenAIRE |
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