{
  "abstract": "Purpose This article explains the endovascular techniques utilized to cure complex AVMs (Yakes Type IIIa AVMs and IIIb AVMs) and the innovative combined transvascular and direct puncture access techniques utilizing ethanol and coils for curative treatment strategies at long-term arteriographic follow-up.Materials & Methods Four patients presented for evaluation and treatment (2 patients intraspinal canal AVMs; 1 patient massive intraspinal and paraspinal multiple AVMs; 1 patient paraspinal AVM) presented with pain syndrome, lower extremity weakness and paresis issues; Ages 22-52, mean 27; 2 males, 2 females). A combination of techniques (transcatheter endovascular arterial access, direct puncture access, retrograde vein access) were employed.Results All 4 patients were cured by these various techniques at long-term follow-up arteriographically (Follow-up: 2-8 years; Mean 3.6 years).Conclusions Innovative access techniques utilized to access the vein aneurysm of the AVM nidus and the use of ethanol and coils has proved curative in treating endovascularly alone complex intracanal and paraspinal Yakes Type IIIa/IIb AVMs obviating surgery. Mean follow-up of over 3 years documents the endovascular curative potential using ethanol and coils as embolic agents alone.Disclosures W. Yakes: None.",
  "authors": [
    {
      "affiliations": [
        "The Yakes Vascular Malformation Center, Englewood, CO"
      ],
      "name": "W Yakes"
    }
  ],
  "title": "E-178 Curative endovascular treatment strategies of spinal canal and paraspinal AVMs: focus on the yakes AVM classification directing the retrograde vein approach access",
  "uid": "1f9aad19-ab18-5311-aaea-40f67c1a5cd3"
}