Journal article
Endovascular treatment of dural arteriovenous fistulas involving the vein of Galen: a single-center cohort and meta-analysis
Journal of neurointerventional surgery, Vol.16(12), pp.1320-1326
12/2024
DOI: 10.1136/jnis-2023-020843
Abstract
Background Dural arteriovenous fistulas (dAVFs) draining into the vein of Galen (VoG) are complex lesions that often necessitate treatment to minimize the risk of rupture and relieve symptoms. These lesions can be treated with open surgical resection, radiosurgery, or endovascular embolization. Unfortunately, endovascular treatment of dAVFs involving the VoG has not been robustly assessed across large patient cohorts. To meet this need, we performed a retrospective review of dAVFs involving the VoG at our center, and included these in a meta-analysis to identify the safety and efficacy of endovascular embolization, as well as describing current treatment trends for this disease. Methods Consecutive patients with dAVFs involving the VoG treated at a single center were identified from a prospective database and retrospectively reviewed. A literature search was conducted with defined search criteria, and eligible studies were included alongside our cohort in a meta-analysis. Rates of complete dAVF treatment and clinical complications were pooled across studies with a random effects model and reported with a 95% CI. Results Five dAVFs involving the VoG were treated endovascularly at our center during the study period. In this series, 80% of treatments led to complete occlusion of the fistula while no patients had clinical complications. Onyx was used for all treatments. In our meta-analysis, the overall rate of complete occlusion was 72.0% (95% CI 59.8% to 84.1%) and the overall rate of clinical complications was 10.0% (95% CI 4.7% to 15.3%). Conclusions Endovascular approaches for dAVFs involving the VoG are technically feasible, but carry a risk of clinical complications. Future work should identify optimal endovascular embolic agents.
Details
- Title: Subtitle
- Endovascular treatment of dural arteriovenous fistulas involving the vein of Galen: a single-center cohort and meta-analysis
- Creators
- David C Lauzier - Washington University in St. LouisHenrik Ullman - Washington University in St. Louis School of MedicineAngela Hardi - Washington University in St. LouisColin Derdeyn - University of IowaDewitte T Cross - Washington University in St. Louis School of MedicineChristopher J Moran - Washington University in St. Louis School of Medicine
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.16(12), pp.1320-1326
- DOI
- 10.1136/jnis-2023-020843
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Language
- English
- Electronic publication date
- 09/30/2023
- Date published
- 12/2024
- Academic Unit
- Radiology; Neurosurgery; Neurology; Iowa Neuroscience Institute
- Record Identifier
- 9984473475402771
Metrics
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