Matthew J Koch1, Christopher J Stapleton2, Ridhima Guniganti3, Giuseppe Lanzino4, Jason Sheehan5, Ali Alaraj1, Diederik Bulters6, Louis Kim7, W Christopher Fox8, Bradley A Gross9, Minako Hayakawa10, J Marc C van DijK11, Robert M Starke12, Junichiro Satomi13, Adam J Polifka14, Gregory J Zipfel3, Sepideh Amin-Hanjani1. 1. Department of Neurosurgery, University of Illinois at Chicago, Chicago (M.J.K., A.A., S.A.-H.). 2. Department of Neurosurgery, Massachusetts General Hospital, Boston (C.J.S.). 3. Department of Neurological Surgery, Washington University, St. Louis, MO (R.G., G.J.Z.). 4. Department of Neurosurgery (G.L.), Mayo Clinic, Rochester, MN. 5. Department of Neurosurgery, University of Virginia, Charlottesville (J.S.). 6. Department of Neurosurgery, University Hospital Southampton, England (D.B.). 7. Department of Neurological Surgery, University of Washington, Seattle, VA (L.K.). 8. Department of Neurosurgery, Mayo Clinic, Jacksonville, FL (W.C.F.). 9. Department of Neurosurgery, University of Pittsburgh, PA (B.A.G.). 10. Department of Radiology, University of Iowa, Iowa City (M.H.). 11. Department of Neurosurgery, University of Groningen, the Netherlands (J.M.C.v.D.). 12. Department of Neurosurgery, University of Miami, FL (R.M.S.). 13. Department of Neurosurgery, Tokushima University, Japan (J.S.). 14. Department of Neurosurgery, University of Florida, Gainesville (A.J.P.).
Abstract
Background and Purpose: Dural arteriovenous fistulae can present with hemorrhage, but there remains a paucity of data regarding subsequent outcomes. We sought to use the CONDOR (Consortium for Dural Arteriovenous Fistula Outcomes Research), a multi-institutional registry, to characterize the morbidity and mortality of dural arteriovenous fistula–related hemorrhage. Methods: A retrospective review of patients in CONDOR who presented with dural arteriovenous fistula–related hemorrhage was performed. Patient characteristics, clinical follow-up, and radiographic details were analyzed for associations with poor outcome (defined as modified Rankin Scale score ≥3). Results: The CONDOR dataset yielded 262 patients with incident hemorrhage, with median follow-up of 1.4 years. Poor outcome was observed in 17.0% (95% CI, 12.3%–21.7%) at follow-up, including a 3.6% (95% CI, 1.3%–6.0%) mortality. Age and anticoagulant use were associated with poor outcome on multivariable analysis (odds ratio, 1.04, odds ratio, 5.1 respectively). Subtype of hemorrhage and venous shunting pattern of the lesion did not affect outcome significantly. Conclusions: Within the CONDOR registry, dural arteriovenous fistula–related hemorrhage was associated with a relatively lower morbidity and mortality than published outcomes from other arterialized cerebrovascular lesions but still at clinically consequential rates.
Background and Purpose: Dural arteriovenous fistulae can present with hemorrhage, but there remains a paucity of data regarding subsequent outcomes. We sought to use the CONDOR (Consortium for Dural Arteriovenous Fistula Outcomes Research), a multi-institutional registry, to characterize the morbidity and mortality of dural arteriovenous fistula–related hemorrhage. Methods: A retrospective review of patients in CONDOR who presented with dural arteriovenous fistula–related hemorrhage was performed. Patient characteristics, clinical follow-up, and radiographic details were analyzed for associations with poor outcome (defined as modified Rankin Scale score ≥3). Results: The CONDOR dataset yielded 262 patients with incident hemorrhage, with median follow-up of 1.4 years. Poor outcome was observed in 17.0% (95% CI, 12.3%–21.7%) at follow-up, including a 3.6% (95% CI, 1.3%–6.0%) mortality. Age and anticoagulant use were associated with poor outcome on multivariable analysis (odds ratio, 1.04, odds ratio, 5.1 respectively). Subtype of hemorrhage and venous shunting pattern of the lesion did not affect outcome significantly. Conclusions: Within the CONDOR registry, dural arteriovenous fistula–related hemorrhage was associated with a relatively lower morbidity and mortality than published outcomes from other arterialized cerebrovascular lesions but still at clinically consequential rates.
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Authors: Ridhima Guniganti; Enrico Giordan; Ching-Jen Chen; Isaac Josh Abecassis; Michael R Levitt; Andrew Durnford; Jessica Smith; Edgar A Samaniego; Colin P Derdeyn; Amanda Kwasnicki; Ali Alaraj; Adriaan R E Potgieser; Samir Sur; Stephanie H Chen; Yoshiteru Tada; Ethan Winkler; Ryan R L Phelps; Pui Man Rosalind Lai; Rose Du; Adib Abla; Junichiro Satomi; Robert M Starke; J Marc C van Dijk; Sepideh Amin-Hanjani; Minako Hayakawa; Bradley A Gross; W Christopher Fox; Diederik Bulters; Louis J Kim; Jason Sheehan; Giuseppe Lanzino; Jay F Piccirillo; Akash P Kansagra; Gregory J Zipfel Journal: J Neurosurg Date: 2021-09-10 Impact factor: 5.115
Authors: W M T Jolink; J M C van Dijk; C J J van Asch; G A P de Kort; A Algra; R J M Groen; G J E Rinkel; C J M Klijn Journal: J Neurol Date: 2015-09-26 Impact factor: 4.849