BACKGROUND AND PURPOSE: Dural arteriovenous shunt (DAVS) is a disease in which abnormal arteriovenous communications develop within the dura. Some case series have suggested DAVS may evolve over time, but the natural history is poorly understood. In this study, we aimed to define the incidence and clinical characteristics of patients with DAVS showing spontaneous angiographic pattern conversion. METHODS: We assessed clinical and angiographic features of patients with angiographic conversion without any treatment from a single center database consisting of 335 DAVS cases. Spontaneous angiographic conversion was defined as complete occlusion of a pre-existing DAVS or conversion of a benign into an aggressive lesion on follow-up diagnostic subtraction angiography. RESULTS: One hundred twelve patients were followed without treatment after the initial diagnosis of DAVS. Overall, we saw pattern conversion on angiography in 18 of the 112 cases (16.1%). Fourteen patients showed spontaneous occlusion of the shunt (12.5%); the most common locations of spontaneous obliteration were the transverse and cavernous sinuses. Four patients showed conversion to an aggressive lesion from benign DAVS (4.0%); all of these cases were associated with occlusion of the ipsilateral draining vein. CONCLUSIONS: DAVS is a dynamic disorder, which will show chronological progression. Spontaneous angiographic obliteration or conversion into an aggressive type may occur on follow-up of untreated DAVSs.
BACKGROUND AND PURPOSE: Dural arteriovenous shunt (DAVS) is a disease in which abnormal arteriovenous communications develop within the dura. Some case series have suggested DAVS may evolve over time, but the natural history is poorly understood. In this study, we aimed to define the incidence and clinical characteristics of patients with DAVS showing spontaneous angiographic pattern conversion. METHODS: We assessed clinical and angiographic features of patients with angiographic conversion without any treatment from a single center database consisting of 335 DAVS cases. Spontaneous angiographic conversion was defined as complete occlusion of a pre-existing DAVS or conversion of a benign into an aggressive lesion on follow-up diagnostic subtraction angiography. RESULTS: One hundred twelve patients were followed without treatment after the initial diagnosis of DAVS. Overall, we saw pattern conversion on angiography in 18 of the 112 cases (16.1%). Fourteen patients showed spontaneous occlusion of the shunt (12.5%); the most common locations of spontaneous obliteration were the transverse and cavernous sinuses. Four patients showed conversion to an aggressive lesion from benign DAVS (4.0%); all of these cases were associated with occlusion of the ipsilateral draining vein. CONCLUSIONS:DAVS is a dynamic disorder, which will show chronological progression. Spontaneous angiographic obliteration or conversion into an aggressive type may occur on follow-up of untreated DAVSs.
Authors: Na-Young Shin; Young Sub Kwon; Sam Yeol Ha; Byung Moon Kim; Dong Ik Kim; Dong Joon Kim Journal: Neuroradiology Date: 2013-06-26 Impact factor: 2.804
Authors: S W Hetts; T Tsai; D L Cooke; M R Amans; F Settecase; P Moftakhar; C F Dowd; R T Higashida; M T Lawton; V V Halbach Journal: AJNR Am J Neuroradiol Date: 2015-07-23 Impact factor: 3.825
Authors: Jai Ho Choi; Kyung Il Jo; Keon Ha Kim; Pyoung Jeon; Je Young Yeon; Jong Soo Kim; Seung Chyul Hong Journal: Neuroradiology Date: 2015-09-28 Impact factor: 2.804