Transarterial Embolization of Anterior Cranial Fossa Dural AVFs As a First-Line Approach: A Single-Center Study

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2024 Jan 4

PMID 38176732

Authors

Carl A J Puylaert

Rene van den Berg

Bert A Coert

Bart J Emmer

Affiliations

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Abstract

Background And Purpose: Endovascular treatment has been increasingly used for anterior cranial fossa dural AVFs. Evidence on the safety and efficacy of different endovascular treatment strategies is limited. We report clinical and angiographic outcomes of patients with anterior cranial fossa dural AVFs who underwent treatment using transarterial embolization with BCA as a first-line approach.

Materials And Methods: Consecutive patients undergoing treatment for anterior cranial fossa dural AVFs at the Amsterdam University Medical Centers between 2010 and 2023 were retrospectively included. Transarterial embolization was used as a first-line approach, while transvenous treatment and surgery were used in cases of unsuccessful transarterial embolization. Treatment was evaluated on the basis of the angiographic cure rate, procedural complications, and clinical outcome.

Results: Fourteen patients were included with 15 anterior cranial fossa dural AVFs. All patients underwent primary endovascular treatment (12 transarterial, 1 transvenous, and 1 combined). Complete occlusion using only transarterial embolization was reached in 69% of patients (9/13), while the overall complete occlusion by endovascular treatment was reached in 79% of patients (11/14). Navigation and embolization were performed through the ophthalmic artery in 13 patients, with no procedural complications. Visual acuity was preserved in all patients. Three patients underwent an operation after failed endovascular treatment. All patients had complete anterior cranial fossa dural AVF occlusion at follow-up.

Conclusions: Treatment of anterior cranial fossa dural AVFs using transarterial embolization with BCA as a first-line approach is a safe and feasible first-line treatment strategy. No visual complications due to embolization through the ophthalmic artery occurred in this study.

Citing Articles

Regarding "Transarterial Embolization of Anterior Cranial Fossa Dural AVFs as a First-Line Approach: A Single-Center Study".

Su X, Ma Y, Song Z, Zhang H, Zhang P, Ye M AJNR Am J Neuroradiol. 2024; 45(8):E34.

PMID: 39054296 PMC: 11383414. DOI: 10.3174/ajnr.A8257.

Feasibility, safety, and efficacy of endovascular treatment of anterior cranial fossa dural arteriovenous fistulas: a systematic review and meta-analysis with a subanalysis for Onyx.

Ferreira M, Gunkan A, Batista S, Porto M, Camerotte R, de Barros Oliveira L Neurosurg Rev. 2024; 47(1):217.

PMID: 38736006 DOI: 10.1007/s10143-024-02446-5.

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