Journal article
Endovascular embolization of high-grade cerebral dural arteriovenous fistulas-assessment of long-term recurrences
Interventional neuroradiology, Vol.28(4), pp.411-418
09/13/2021
DOI: 10.1177/15910199211038277
PMCID: PMC9326856
PMID: 34516298
Abstract
Introduction Endovascular therapy has shown to be safe and effective for the treatment of cerebral dural arteriovenous fistulas; however, recurrence after complete occlusion is not uncommon, and the timing of recurrence remains unknown. Methods A retrospective single-center cohort study was conducted from January 2005 to December 2020. Patients with high-grade (>= Borden II-Cognard IIB) dural arteriovenous fistulas treated with endovascular therapy were included in this study. Clinical and angiographic characteristics were collected for hospitalization and at follow-up. Results A total of 51 patients with a median age of 61 years were studied; 57% were female. High-flow symptoms related to the high-flow fistula were the most common presentation (67%), and 24% presented with intracranial hemorrhage. Transverse-sigmoid (26%) and cavernous (26%) sinuses were the most common dural arteriovenous fistula locations. A total of 40 patients (70%) had middle meningeal arterial feeders and 4 (7%) had deep cerebral venous drainage. The mean number of embolization procedures per patient was 1.4. Transarterial access was the most frequent approach (61%). Onyx alone was the most common embolic agent (26%). Complete occlusion rate was achieved in 46 patients (80.1%). Last mean radiographic follow-up time was 26.7 months for all 57 dural arteriovenous fistulas. Dural arteriovenous fistula recurrence after radiographic resolution at last treatment was seen in six cases (6/46, 13.1%). Mean time for recurrence was 15.8 months. Mean time of last clinical follow-up was 46.1 months for the 51 patients (100%). A total of 10 (20%) experienced any procedural complications, among which two (4%) became major thromboembolic events. Conclusion Endovascular therapy is safe and effective for the treatment of high-grade dural arteriovenous fistulas. Given the significant recurrence rate of embolized dural arteriovenous fistulas even after 2 years, long-term angiographic follow-up might be needed.
Details
- Title: Subtitle
- Endovascular embolization of high-grade cerebral dural arteriovenous fistulas-assessment of long-term recurrences
- Creators
- Alan Mendez-Ruiz - University of IowaWaldo R. Guerrero - Florida CollegeViktor Szeder - University of California, Los AngelesMudassir Farooqui - University of IowaCynthia B. Zevallos - University of IowaDarko Quispe-Orozco - University of Iowa Hospitals and ClinicsSantiago Ortega-Gutierrez - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Interventional neuroradiology, Vol.28(4), pp.411-418
- DOI
- 10.1177/15910199211038277
- PMID
- 34516298
- PMCID
- PMC9326856
- NLM abbreviation
- Interv Neuroradiol
- ISSN
- 1591-0199
- eISSN
- 2385-2011
- Publisher
- Sage
- Number of pages
- 8
- Language
- English
- Date published
- 09/13/2021
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984302204902771
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