Guilherme Dabus1,2, Peter Kan3, Carlos Diaz4, Boris Pabon5, Juan Andres-Mejia5, Italo Linfante6, Jonathan A Grossberg7, Brian M Howard7, Civan Islak8, Naci Kocer8, Osman Kizilkilic8, Ajit S Puri9, Anna L Kuhn9, Viraj Moholkar9, Santiago Ortega-Gutierrez10, Edgar A Samaniego10, Michael W McDermott6. 1. Division of Interventional Neuroradiology/NeuroEndovascular Surgery, Miami Neuroscience Institute - Baptist Hospital, Miami, FL, USA. guilhermed@baptisthealth.net. 2. Miami Cardiac & Vascular Institute, 8900 N. Kendall Drive, Miami, FL, 33176, USA. guilhermed@baptisthealth.net. 3. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA. 4. Interventional Neuroradiology at Incare, Universidad de Antioquia, Medellin, Colombia. 5. Interventional Neuroradiology at Angioteam, Medellin, Colombia. 6. Division of Interventional Neuroradiology/NeuroEndovascular Surgery, Miami Neuroscience Institute - Baptist Hospital, Miami, FL, USA. 7. Department of Neurosurgery, Emory University, Atlanta, GA, USA. 8. Department of Neuroradiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey. 9. Department of Radiology, University of Massachusetts, Worcester, MA, USA. 10. Department of Neurology and Radiology, University of Iowa, Iowa City, IA, USA.
Abstract
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.
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.
Authors: Michael E Kelly; Raymond Turner; Vivek Gonugunta; Peter A Rasmussen; Henry H Woo; David Fiorella Journal: Neurosurgery Date: 2008-07 Impact factor: 4.654
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Authors: Alan Mendez-Ruiz; Waldo R Guerrero; Viktor Szeder; Mudassir Farooqui; Cynthia B Zevallos; Darko Quispe-Orozco; Santiago Ortega-Gutierrez Journal: Interv Neuroradiol Date: 2021-09-13 Impact factor: 1.764