{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:09:42Z","timestamp":1791637782379,"version":"4.3.4"},"reference-count":126,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Empa Research Booster program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Spinal vascular malformations (SVMs) are rare and heterogeneous lesions that may lead to progressive neurological decline or hemorrhage, posing significant challenges for management due to their complex angioarchitecture and proximity to critical neural structures. This review examines the role of angiographic imaging modalities used intraoperatively and postoperatively in guiding treatment, confirming therapeutic success, and informing follow-up strategies. We summarize evidence on two-dimensional digital subtraction angiography (2D DSA), indocyanine green videoangiography (ICG\u2013VAG), and emerging adjunctive techniques. 2D DSA remains the reference standard, offering superior temporal and spatial resolution for real-time visualization of vascular anatomy, catheter navigation, and embolic delivery, though its invasive nature, radiation exposure, and two-dimensional projection limit long-term applicability. ICG\u2013VAG provides a complementary, non-ionizing method for intraoperative fluorescence imaging, aiding in shunt localization and venous preservation, although its restricted field of view and limited capacity for quantitative analysis reduce its standalone value. Advances in quantitative angiographic metrics, patient-specific hemodynamic modeling, and artificial intelligence-driven image analysis are anticipated to enhance diagnostic accuracy and reproducibility. The development of standardized multimodal protocols will be crucial for optimizing patient-centered treatment of these complex and rare lesions.<\/jats:p>","DOI":"10.3390\/medsci13040266","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T09:59:09Z","timestamp":1763027949000},"page":"266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Role of Angiographic Imaging in the Treatment of Spinal Vascular Malformations"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7051-7056","authenticated-orcid":false,"given":"Camilla Giulia","family":"Calastra","sequence":"first","affiliation":[{"name":"Center for X-Ray Analytics, Empa\u2014Swiss Federal Laboratories for Materials Science and Technology, \u00dcberlandstrasse 129, 8600 D\u00fcbendorf, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada","family":"Ayechu Abenda\u00f1o","sequence":"additional","affiliation":[{"name":"Mechanical Systems Engineering, Empa\u2014Swiss Federal Laboratories for Materials Science and Technology, \u00dcberlandstrasse 129, 8600 D\u00fcbendorf, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1161-7931","authenticated-orcid":false,"given":"Raluca-Ana-Maria","family":"Barna","sequence":"additional","affiliation":[{"name":"Center for X-Ray Analytics, Empa\u2014Swiss Federal Laboratories for Materials Science and Technology, \u00dcberlandstrasse 129, 8600 D\u00fcbendorf, Switzerland"},{"name":"Faculty of Medicine, University of Bern, Hochschulstrasse 6, 3012 Bern, Switzerland"},{"name":"Spine Biomechanics, Balgrist University Hospital, Lengghalde 5, 8008 Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1737-8311","authenticated-orcid":false,"given":"Federica","family":"Orellana","sequence":"additional","affiliation":[{"name":"Center for X-Ray Analytics, Empa\u2014Swiss Federal Laboratories for Materials Science and Technology, \u00dcberlandstrasse 129, 8600 D\u00fcbendorf, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6059-9703","authenticated-orcid":false,"given":"Simone","family":"Baffelli","sequence":"additional","affiliation":[{"name":"Scientific IT, Empa\u2014Swiss Federal Laboratories for Materials Science and Technology, \u00dcberlandstrasse 129, 8600 D\u00fcbendorf, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9489-3003","authenticated-orcid":false,"given":"Ameet","family":"Aiyangar","sequence":"additional","affiliation":[{"name":"Mechanical Systems Engineering, Empa\u2014Swiss Federal Laboratories for Materials Science and Technology, \u00dcberlandstrasse 129, 8600 D\u00fcbendorf, Switzerland"},{"name":"Faculty of Medicine, University of Bern, Hochschulstrasse 6, 3012 Bern, Switzerland"},{"name":"Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, Bern University Hospital, University of Bern, Rosenb\u00fchlgasse 27, 3010 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0251-5094","authenticated-orcid":false,"given":"Annapaola","family":"Parrilli","sequence":"additional","affiliation":[{"name":"Center for X-Ray Analytics, Empa\u2014Swiss Federal Laboratories for Materials Science and Technology, \u00dcberlandstrasse 129, 8600 D\u00fcbendorf, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1227\/01.NEU.0000374721.84406.7F","article-title":"Indocyanine Green Videoangiography in the Management of Dural Arteriovenous Fistulae","volume":"67","author":"Schuette","year":"2010","journal-title":"Neurosurgery"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s10143-016-0713-z","article-title":"Spinal vascular malformations: Treatment strategies and outcome","volume":"40","author":"Flores","year":"2017","journal-title":"Neurosurg. 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