Article Text

PDF
Electronic poster abstract
E-041 Combined endovascular embolization and surgical resection of a massive lumbosacral arteriovenous malformation in a patient with Cobb syndrome
  1. A Spiotta,
  2. M Hussain,
  3. T Sivapatham,
  4. T Masaryk,
  5. A Krishnaney
  1. Neurological Surgery, Cleveland Clinic, Cleveland, Ohio, USA

Abstract

Objective and importance Cobb syndrome is a rare condition that includes a cutaneous nevus with an associated spinal vascular lesion at the same dermatome. We present a challenging case of a progressively symptomatic massive lumbosacral arteriovenous malformations (AVM) in a patient with Cobb's syndrome requiring a multimodality approach, including staged preoperative transarterial and transvenous endovascular embolization followed by surgical excision and wound reconstruction.

Clinical presentation The patient is a 25-year-old man with a massive lumbosacral AVM with symptoms of congestive heart failure. Angiography demonstrated arterial feeders predominantly from the internal iliac, median sacral and lumbar segmental arteries.

Intervention The patient underwent staged transarterial and transvenous endovascular embolization resulting in 90% reduction in the AVM size, followed by surgical resection of the lesion. The patient made an excellent recovery with improvement in his symptoms of congestive heart failure.

Conclusion The treatment algorithm for massive AVMs must be individualized. A combination of staged embolization and subsequent surgery may be required to obtain a good result. Through this carefully planned multidisciplinary approach, a previously incurable lesion in this patient with Cobb syndrome was able to be treated successfully.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.