Journal article
Risk of Early Versus Later Rebleeding From Dural Arteriovenous Fistulas With Cortical Venous Drainage
Stroke (1970), Vol.53(7), pp.2340-2345
04/14/2022
DOI: 10.1161/STROKEAHA.121.036450
PMCID: PMC9232241
PMID: 35420453
Abstract
Cranial dural arteriovenous fistulas with cortical venous drainage are rare lesions that can present with hemorrhage. A high rate of rebleeding in the early period following hemorrhage has been reported, but published long-term rates are much lower. No study has examined how risk of rebleeding changes over time. Our objective was to quantify the relative incidence of rebleeding in the early and later periods following hemorrhage.
Patients with dural arteriovenous fistula and cortical venous drainage presenting with hemorrhage were identified from the multinational CONDOR (Consortium for Dural Fistula Outcomes Research) database. Natural history follow-up was defined as time from hemorrhage to first treatment, rebleed, or last follow-up. Rebleeding in the first 2 weeks and first year were compared using incidence rate ratio and difference.
Of 1077 patients, 250 met the inclusion criteria and had 95 cumulative person-years natural history follow-up. The overall annualized rebleed rate was 7.3% (95% CI, 3.2-14.5). The incidence rate of rebleeding in the first 2 weeks was 0.0011 per person-day; an early rebleed risk of 1.6% in the first 14 days (95% CI, 0.3-5.1). For the remainder of the first year, the incidence rate was 0.00015 per person-day; a rebleed rate of 5.3% (CI, 1.7-12.4) over 1 year. The incidence rate ratio was 7.3 (95% CI, 1.4-37.7;
, 0.026).
The risk of rebleeding of a dural arteriovenous fistula with cortical venous drainage presenting with hemorrhage is increased in the first 2 weeks justifying early treatment. However, the magnitude of this increase may be considerably lower than previously thought. Treatment within 5 days was associated with a low rate of rebleeding and appears an appropriate timeframe.
Details
- Title: Subtitle
- Risk of Early Versus Later Rebleeding From Dural Arteriovenous Fistulas With Cortical Venous Drainage
- Creators
- Andrew J Durnford - University of SouthamptonDanyal Akarca - University of CambridgeDavid Culliford - University of SouthamptonJohn Millar - Wessex Neurological Center, University Hospital Southampton, United Kingdom. (A.J.D., D.A., J.M.)Ridhima Guniganti - Washington University in St. LouisEnrico Giordan - Department of Radiology, Mayo Clinic, Rochester, MN. (E.G., W.B., G.L.)Waleed Brinjikji - Department of Radiology, Mayo Clinic, Rochester, MN. (E.G., W.B., G.L.)Ching-Jen Chen - University of VirginiaIsaac Josh Abecassis - University of WashingtonMichael Levitt - University of WashingtonAdam J Polifka - University of FloridaColin P Derdeyn - University of Iowa, RadiologyEdgar A Samaniego - University of Iowa, NeurologyAmanda Kwasnicki - University of Illinois ChicagoAli Alaraj - University of Illinois ChicagoAdriaan R E Potgieser - University Medical Center GroningenStephanie Chen - University of MiamiYoshiteru Tada - Department of Neurosurgery, Institute of Biomedical Biosciences, Tokushima University Graduate School, Japan (Y.T., J.S.)Ryan Phelps - University of California, San FranciscoAdib Abla - University of PittsburghJunichiro Satomi - Department of Neurosurgery, Institute of Biomedical Biosciences, Tokushima University Graduate School, Japan (Y.T., J.S.)Robert M Starke - University of MiamiJ Marc C van Dijk - University Medical Center GroningenSepideh Amin-Hanjani - University of Illinois ChicagoMinako Hayakawa - University of Iowa, RadiologyBradley Gross - University of PittsburghW Christopher Fox - University of FloridaLouis Kim - University of WashingtonJason Sheehan - University of Virginia Health SystemGiuseppe Lanzino - Department of Radiology, Mayo Clinic, Rochester, MN. (E.G., W.B., G.L.)Akash P Kansagra - Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO (A.P.K.)Rose Du - Brigham and Women's HospitalRosalind Lai - Brigham and Women's HospitalGregory J Zipfel - Washington University in St. LouisDiederik O BultersCONDOR Investigators
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.53(7), pp.2340-2345
- DOI
- 10.1161/STROKEAHA.121.036450
- PMID
- 35420453
- PMCID
- PMC9232241
- NLM abbreviation
- Stroke
- eISSN
- 1524-4628
- Language
- English
- Electronic publication date
- 04/14/2022
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984242755002771
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