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

Ricardo A.  Hanel; Stephen  Pirris; Ramon  Navarro

doi:10.4236/ojmn.2014.44035

OJMN Vol.4 No.4 , October 2014

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

Ramon Navarro, Stephen Pirris^*, Ricardo A. Hanel

Abstract: 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.

Keywords: Spinal Navigation, Vascular Malformation, Klippel-Trenaunay, Image Guidance, Endovascular Embolization

Cite this paper: Navarro, R. , Pirris, S. and Hanel, R. (2014) Endovascular Treatment and Selective Image Guided Partial Resection of Epidural Spinal Vascular Malformation in Klippel-Trenaunay Syndrome: Case Report. Open Journal of Modern Neurosurgery, 4, 196-201. doi: 10.4236/ojmn.2014.44035.

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