Report on the symposium organized in antwerp on 23.05.2013: new milestones in vascular interventions

During the last decade, we have witnessed nothing short of a revolution in angiography and vascular (neuro)interventional radiology. Developments in technology and equipment have opened a fascinating world of near-limitless possibilities. Minimally invasive endovascular treatments have been developed and optimized for numerous indications where, previously, open surgery was the only option. Thanks to the implementation of new angiographic equipment and new materials (such as stents, coils, catheters, etc.), we are now able to treat patients with less invasive means. In order to deal with complex vascular lesions, multidisciplinary teams (with active participation of various medical specialists) have found their way to the angiography suite and vascular intervention unit, which has become a viable alternative to the operating room (OR). This has led to a significant increase in the number of vascular procedures and interventions performed in the department of radiology

A Spinal Arteriovenous Fistula in a 3-Year Old Boy

We present a case of a 3-year-old boy with neurodegeneration. Family history reveals Rendu-Osler-Weber disease. Magnetic resonance imaging (MRI) of the spinal cord and spinal angiography showed a spinal arteriovenous fistula with venous aneurysm, causing compression of the lumbar spinal cord. Embolisation of the fistula was executed, resulting in clinical improvement. A week after discharge he was readmitted with neurologic regression. A second MRI scan revealed an intraspinal epidural haematoma and increase in size of the aneurysm with several new arterial feeders leading to it. Coiling of the aneurysm and fistulas was performed. Postoperative, the spinal oedema increased despite corticoids, causing more extensive paraplegia of the lower limbs and a deterioration of his mental state. A laminectomy was performed and the aneurysm was surgically removed. Subsequently, the boy recovered gradually. A new MRI scan after two months showed less oedema and a split, partly affected spinal chord. This case shows the importance of excluding possible arteriovenous malformations in a child presenting with progressive neurodegeneration. In particular when there is a family history for Rendu-Osler-Weber disease, scans should be performed instantly to rule out this possibility. The case also highlights the possibility of good recovery of paraplegia in paediatric Rendu-Osler-Weber patients