Endovascular Treatment and Selective Image Guided Partial Resection of Epidural Spinal Vascular Malformation in Klippel-Trenaunay Syndrome: Case Report

• 作者: Ramon Navarro Ricardo A. Hanel Stephen Pirris
• 来源期刊: 现代神经外科学进展(英文)
• 学科: 医学
• 关键词: SPINAL Navigation VASCULAR MALFORMATION Klippel-Trenaunay Image Guidance ENDOVASCULAR EMBOLIZATION
• 年，卷（期）: 2014,（4）
• 页码范围: 196-201
• 页数: 6页
• 分类号: R73

摘要

Background: Klippel-Trenaunay-Weber syndrome is a rare congenital condition that may involve the central nervous system with extensive vascular malformations, and soft-tissue hypertrophy of the affected limb. Methods: A 51-year-old patient underwent previous procedures including decompressive laminectomy and endovascular embolization using Onyx and a self-expandable stent. However, recanalization of the malformation was observed, his symptoms progressed, and the decision was made to undergo selective surgical resection with intraoperative image guidance using Stealth system paired with the O-arm. Results: Adequate decompression of the affected spinal cord and cervical roots were obtained, and the patient’s symptoms improved. Conclusion: Since the typical anatomic landmarks were obliterated by the extensive vascular malformation and previous surgery, intraoperative image guidance proved to be very beneficial. This case reports on the usage of spinal navigation to efficiently dissect out the affected nerve roots and avoid vascular injury by referencing the Onyx and stent.