Title

Endovascular treatment of anterior cranial fossa dural arteriovenous fistula: a multicenter series

UMMS Affiliation

Department of Radiology

Publication Date

2020-08-25

Document Type

Article

Disciplines

Cardiovascular Diseases | Neurology | Neurosurgery | Radiology

Abstract

PURPOSE: We report a multicenter experience using endovascular embolization as the first line approach for treatment of anterior cranial fossa (ACF) dural arteriovenous fistula (DAVF).

METHODS: All patients with DAVFs located in the anterior cranial fossa who were treated with endovascular technique as a first line approach were included. Demographics, clinical presentation, angioarchitecture, strategy, complications, immediate angiographic, and follow-up results were included in the analysis.

RESULTS: Twenty-three patients met the inclusion criteria (18 male and 5 female). Age ranged from 14 to 79 years (mean 53 years). Twelve patients presented with hemorrhage. Twenty-eight endovascular procedures were performed. The overall immediate angiographic cure rate after endovascular treatment was 82.6% (19/23 patients). The angiographic cure rate of the transvenous strategy was significantly superior to the transarterial strategy (p < /= 0.001). There was 1 complication in 28 total procedures (3.6%). Angiographic follow-up was available in 21 out of the 23 patients with a mean of 25 months (range 2 to 108 months). In these 21 patients, the DAVF was completely cured in 20 (95%). At last follow-up, all patients had a modified Rankin scale (mRS) 0 to 2.

CONCLUSION: Our experience suggests that endovascular treatment for ACF DAVFs has an acceptable safety profile with high rates of complete occlusion, particularly with transvenous approach. Whenever possible, transvenous approach should be preferred over transarterial approach as first line strategy.

Keywords

Anterior cranial fossa, Dural arteriovenous fistula, Embolization, Endovascular, Ethmoidal, Transarterial, Transvenous

DOI of Published Version

10.1007/s00234-020-02536-3

Source

Dabus G, Kan P, Diaz C, Pabon B, Andres-Mejia J, Linfante I, Grossberg JA, Howard BM, Islak C, Kocer N, Kizilkilic O, Puri AS, Kuhn AL, Moholkar V, Ortega-Gutierrez S, Samaniego EA, McDermott MW. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula: a multicenter series. Neuroradiology. 2020 Aug 25. doi: 10.1007/s00234-020-02536-3. Epub ahead of print. PMID: 32840681. Link to article on publisher's site

Journal/Book/Conference Title

Neuroradiology

Related Resources

Link to Article in PubMed

PubMed ID

32840681

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