Endovascular treatment of anterior cranial fossa dural arteriovenous fistula: a multicenter series


Dabus G., Kan P., Diaz C., Pabon B., Andres-Mejia J., Linfante I., ...Daha Fazla

NEURORADIOLOGY, cilt.63, sa.2, ss.259-266, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 63 Sayı: 2
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1007/s00234-020-02536-3
  • Dergi Adı: NEURORADIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Agricultural & Environmental Science Database, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.259-266
  • Anahtar Kelimeler: Anterior cranial fossa, Dural arteriovenous fistula, Embolization, Endovascular, Ethmoidal, Transarterial, Transvenous
  • İstanbul Üniversitesi Adresli: Evet

Özet

Purpose We report a multicenter experience using endovascular embolization as the first line approach for treatment of anterior cranial fossa (ACF) dural arteriovenous fistula (DAVF). Methods All patients with DAVFs located in the anterior cranial fossa who were treated with endovascular technique as a first line approach were included. Demographics, clinical presentation, angioarchitecture, strategy, complications, immediate angiographic, and follow-up results were included in the analysis. Results Twenty-three patients met the inclusion criteria (18 male and 5 female). Age ranged from 14 to 79 years (mean 53 years). Twelve patients presented with hemorrhage. Twenty-eight endovascular procedures were performed. The overall immediate angiographic cure rate after endovascular treatment was 82.6% (19/23 patients). The angiographic cure rate of the transvenous strategy was significantly superior to the transarterial strategy (p <= 0.001). There was 1 complication in 28 total procedures (3.6%). Angiographic follow-up was available in 21 out of the 23 patients with a mean of 25 months (range 2 to 108 months). In these 21 patients, the DAVF was completely cured in 20 (95%). At last follow-up, all patients had a modified Rankin scale (mRS) 0 to 2. Conclusion Our experience suggests that endovascular treatment for ACF DAVFs has an acceptable safety profile with high rates of complete occlusion, particularly with transvenous approach. Whenever possible, transvenous approach should be preferred over transarterial approach as first line strategy.