Dural arteriovenous fistulas: a review of the literature and a presentation of a single institution's experience.
Publication/Presentation Date
1-1-2013
Abstract
OBJECTIVE: Dural arteriovenous fistulas (DAVFs) are arteriovenous shunts from a dural arterial supply to a dural venous channel, typically supplied by pachymeningeal arteries and located near a major venous sinus. A retrospective review was conducted to present the results of endovascular obliteration of DAVFs, with particular emphasis of newer liquid embolic agents, including Onyx-18 (MV3, Irvine, California, USA).
METHODS: A review of the literature was performed, and a presentation of the number of treatments, complications, and outcomes is included here. The number of arterial embolizations and need for transvenous embolization, open surgery, and radiosurgery was assessed as well as normalization of retrograde cortical venous drainage.
RESULTS: Thirty-nine patients (22 men and 17 women) underwent endovascular treatment of DAVFs at our institution from 2001 to 2009. Ages ranged from 39 to 71 years (mean, 48 years). Seventy-nine percent of patients had retrograde cortical venous drainage. The average number of embolizations in all patients was 2.1. Twelve patients underwent 40 embolization treatments with Onyx, with an obliteration rate of 75% and cortical venous drainage obliteration rate of 85%. Seventy-one percent (28/39) of patients had complete treatment of the fistula: 21 by purely endovascular treatment and 7 with endovascular therapy followed by craniotomy, as well as seven patients who underwent stereotactic radiosurgery after embolization.
CONCLUSIONS: Endovascular management of DAVFs is a safe and effective method of treating these complex lesions.
Volume
80
Issue
1-2
First Page
94
Last Page
102
ISSN
1878-8769
Published In/Presented At
Ghobrial, G. M., Marchan, E., Nair, A. K., Dumont, A. S., Tjoumakaris, S. I., Gonzalez, L. F., Rosenwasser, R. H., & Jabbour, P. (2013). Dural arteriovenous fistulas: a review of the literature and a presentation of a single institution's experience. World neurosurgery, 80(1-2), 94–102. https://doi.org/10.1016/j.wneu.2012.01.053
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
22381858
Department(s)
Administration and Leadership
Document Type
Article