L Détraz1, K Orlov2, V Berestov2, V Borodetsky3, A Rouchaud3,4, L G de Abreu Mattos3, C Mounayer3,4. 1. From the Service de Neuroradiologie Interventionnelle et Diagnostique (L.D.), Centre Hospitalier Universitaire de Nantes-Hopital Laennec, Saint-Herblain, France lili.detraz@gmail.com. 2. Department of Neurosurgery (K.O., V. Berestov), E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia. 3. Service de Radiologie (V. Borodetsky, A.R.. L.G.d.A.M., C.M.), Neuroradiologie Interventionnelle, Centre Hospitalier Universitaire de Limoges, Limoges, France. 4. CNRS (A.R., C.M.), XLIM, UMR 7252, University of Limoges, Limoges, France.
Abstract
BACKGROUND AND PURPOSE: Dural AVFs located in the posterior fossa are a rare entity. The objectives of the study were to analyze the anatomy of dural AVFs, their endovascular treatment strategies, and clinical outcomes. MATERIALS AND METHODS: Two centers retrospectively selected patients treated between January 2009 and June 2018 having posterior fossa dural AVFs. We collected patient demographics, clinical presentation, arterial and venous outflow anatomy of the dural AVFs, and treatment outcomes. RESULTS: Twenty-six patients treated endovascularly for posterior fossa dural AVFs, type III, IV, or V, were included. One hundred percent of the dural AVFs were occluded. A transarterial approach was performed in 23 dural AVFs (88.5%); a combined transarterial and transvenous approach, for 2 dural AVFs (7.7%); and a transvenous approach alone, for 1 dural AVF (3.8%). The middle meningeal artery was the most common artery chosen to inject embolic liquid (46%, 12/26). Procedure-related morbidity was 15.4% at 24 hours, 7.7% at discharge, and 0% at 6 months. Procedure-related mortality was 0%. CONCLUSIONS: Endovascular treatment offers high occlusion rates for posterior fossa dural AVFs with low morbidity and mortality rates. The arterial approach is the first-line preferred approach, even if a transvenous or combined approach would be a safe and effective option for patients with favorable anatomy.
BACKGROUND AND PURPOSE:Dural AVFs located in the posterior fossa are a rare entity. The objectives of the study were to analyze the anatomy of dural AVFs, their endovascular treatment strategies, and clinical outcomes. MATERIALS AND METHODS: Two centers retrospectively selected patients treated between January 2009 and June 2018 having posterior fossa dural AVFs. We collected patient demographics, clinical presentation, arterial and venous outflow anatomy of the dural AVFs, and treatment outcomes. RESULTS: Twenty-six patients treated endovascularly for posterior fossa dural AVFs, type III, IV, or V, were included. One hundred percent of the dural AVFs were occluded. A transarterial approach was performed in 23 dural AVFs (88.5%); a combined transarterial and transvenous approach, for 2 dural AVFs (7.7%); and a transvenous approach alone, for 1 dural AVF (3.8%). The middle meningeal artery was the most common artery chosen to inject embolic liquid (46%, 12/26). Procedure-related morbidity was 15.4% at 24 hours, 7.7% at discharge, and 0% at 6 months. Procedure-related mortality was 0%. CONCLUSIONS: Endovascular treatment offers high occlusion rates for posterior fossa dural AVFs with low morbidity and mortality rates. The arterial approach is the first-line preferred approach, even if a transvenous or combined approach would be a safe and effective option for patients with favorable anatomy.
Authors: Seon-Kyu Lee; Steven W Hetts; Van Halbach; Karel terBrugge; Sameer A Ansari; Barb Albani; Todd Abruzzo; Adam Arthur; Michael J Alexander; Felipe C Albuquerque; Blaise Baxter; Ketan R Bulsara; Michael Chen; Josser E Delgado Almandoz; Justin F Fraser; Don Frei; Chirag D Gandhi; Don Heck; Muhammad Shazam Hussain; Michael Kelly; Richard Klucznik; Thabele Leslie-Mazwi; Ryan A McTaggart; Philip M Meyers; Athos Patsalides; Charles Prestigiacomo; G Lee Pride; Robert Starke; Peter Sunenshine; Peter Rasmussen; Mahesh V Jayaraman Journal: J Neurointerv Surg Date: 2015-11-27 Impact factor: 5.836
Authors: Michael F Stiefel; Felipe C Albuquerque; Min S Park; Shervin R Dashti; Cameron G McDougall Journal: Neurosurgery Date: 2009-12 Impact factor: 4.654