Outcome of Endovascular Therapy Aiming for Single-session Obliteration of Intracranial Dural Arteriovenous Fistulas

Overview

Journal Neurol Med Chir (Tokyo)

Specialties Neurology
Neurosurgery

Date 2021 Jun 21

PMID 34148944

Citations 1

Authors

Taichi Ishiguro

Tetsu Satow

Eika Hamano

Go Ikeda

Hidekazu Chikuie

Naoki Hashimura

Masaki Nishimura

Jun C Takahashi

Hiroharu Kataoka

Affiliations

Soon will be listed here.

Abstract

The goal of dural arteriovenous fistula (dAVF) treatment is obliteration of the arteriovenous shunt and/or retrograde leptomeningeal venous drainage (RLVD). Single-session obliteration could improve symptoms early and reduce risk of neurological sequelae. This study investigated the efficacy and adverse events of endovascular therapy (EVT) aiming for single-session obliteration in dAVF treatment. We retrospectively examined post-treatment arteriovenous shunt status, number of treatments per case, treatment-related complications, and long-term outcome in 92 dAVF patients who underwent initial EVT at our institution. Single-session obliteration was intended in all cases, but a second session was performed in cases of partial shunt occlusion or remaining RLVD. Complete occlusion was achieved in 85 cases (92.4%) after the single session; RLVD was obliterated in 66 of the 67 Borden type II and III cases combined (98.5%). A second session was necessary in seven cases (7.6%). Complete shunt obliteration was eventually achieved in all cases. The average number of treatments was 1.08 per case. dAVF-related stroke and mortality did not occur after the treatment. On the other hand, radiation-induced skin erythema and alopecia, although all symptoms were transient, occurred in 26 cases (28.3%). Over an average 60.2-month follow-up period, recurrence was observed in seven cases (7.6%). Single-session obliteration was successful in 92% of cases. Especially, single-session obliteration of RLVD may contribute to early prevent of future stroke events. However, reducing total radiation dose during each session is an issue of further study.

Citing Articles

Bailout using NBCA for incomplete onyx embolization of tentorial dural arteriovenous fistula.

Sugihara M, Fujita A, Kondoh T, Takaishi Y, Tanaka H, Tachizawa N Radiol Case Rep. 2024; 19(11):5153-5157.

PMID: 39263518 PMC: 11388044. DOI: 10.1016/j.radcr.2024.07.138.

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