Treatment of Ethmoidal Dural Arteriovenous Fistulas: A Meta-analysis Comparing Endovascular versus Surgical Treatment.

Publication/Presentation Date

8-1-2019

Abstract

BACKGROUND: Dural arteriovenous fistulas (DAVFs) in the anterior cranial fossa constitute approximately 1%-1.5% of intracranial vascular malformations. Depending on the drainage patterns, the diagnosis of ethmoidal DAVFs should prompt treatment because of the high risk of bleeding. Available treatments strategies are surgical treatment and the endovascular approach.

OBJECTIVE: To compare the surgical treatment with the endovascular therapy in terms of complete obliteration and perioperative adverse events.

METHODS: This study was performed according to the PRISMA guidelines. Eligible studies were identified through a search of PubMed and Cochrane until February 2019. A random effects model meta-analysis of odds ratios (OR) was conducted and the I-square was used to assess heterogeneity. Good outcome was defined as no neurologic deterioration within 30 days after the procedure.

RESULTS: Five studies comprising 81 patients were included in the meta-analysis. Surgical disconnection was superior to endovascular therapy in terms of postprocedural complete obliteration rate (surgery group, 100% [n = 65/65]; endovascular therapy, 47% [n = 15/32]; OR, 32.19; 95% confidence interval, 5.46-189.72; I

CONCLUSIONS: Surgical treatment was superior to endovascular therapy in terms of complete obliteration and overall good outcome. Adverse event rates were similar between the 2 groups. Future studies should be conducted to validate our results.

Volume

128

First Page

593

Last Page

599

ISSN

1878-8769

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

31059849

Department(s)

Administration and Leadership

Document Type

Article

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