Non-invasive characterization of a perimedullary dural arteriovenous fistula with dynamic 320-slice CT angiography

OBJECTIVE Cranial dural arteriovenous fistulas (dAVFs) are rare lesions, hampering efforts to understand them and improve their care. To address this challenge, investigators with an established record of dAVF investigation formed an international, multicenter consortium aimed at better elucidating dAVF pathophysiology, imaging characteristics, natural history, and patient outcomes. This report describes the design of the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR) and includes characterization of the 1077-patient cohort. METHODS Potential collaborators with established interest in the field were identified via systematic review of the literature. To ensure uniformity of data collection, a quality control process was instituted. Data were retrospectively obtained. RESULTS CONDOR comprises 14 centers in the United States, the United Kingdom, the Netherlands, and Japan that have pooled their data from 1077 dAVF patients seen between 1990 and 2017. The cohort includes 359 patients (33%) with Borden type I dAVFs, 175 (16%) with Borden type II fistulas, and 529 (49%) with Borden type III fistulas. Overall, 852 patients (79%) presented with fistula-related symptoms: 427 (40%) presented with nonaggressive symptoms such as tinnitus or orbital phenomena, 258 (24%) presented with intracranial hemorrhage, and 167 (16%) presented with nonhemorrhagic neurological deficits. A smaller proportion (224 patients, 21%), whose dAVFs were discovered incidentally, were asymptomatic. Many patients (85%, 911/1077) underwent treatment via endovascular embolization (55%, 587/1077), surgery (10%, 103/1077), radiosurgery (3%, 36/1077), or multimodal therapy (17%, 184/1077). The overall angiographic cure rate was 83% (758/911 treated), and treatment-related permanent neurological morbidity was 2% (27/1467 total procedures). The median time from diagnosis to follow-up was 380 days (IQR 120–1038.5 days). CONCLUSIONS With more than 1000 patients, the CONDOR registry represents the largest registry of cranial dAVF patient data in the world. These unique, well-annotated data will enable multiple future analyses to be performed to better understand dAVFs and their management.

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Angiographically occult spinal dural arteriovenous fistula located using selective computed tomography angiography

Journal of Neurosurgery Spine ◽

10.3171/spi-07/08/215 ◽

2007 ◽

Vol 7 (2) ◽

pp. 215-220 ◽

Cited By ~ 11

Author(s):

Taku Sugawara ◽

Yoshitaka Hirano ◽

Yasunobu Itoh ◽

Hiroyuki Kinouchi ◽

Satoshi Takahashi ◽

...

Keyword(s):

Computed Tomography ◽

Spinal Cord ◽

Mr Imaging ◽

Arteriovenous Fistula ◽

Ct Angiography ◽

Dural Arteriovenous Fistula ◽

Low Flow ◽

Spinal Dural Arteriovenous Fistula ◽

Coronary Veins ◽

Spinal Arteriovenous Malformation

✓Spinal dural arteriovenous fistula (DAVF) is the most common type of spinal arteriovenous malformation and may cause progressive myelopathy but is usually treatable in the early stages by direct surgery or intravascular embolization. Selective spinal angiography has been the gold standard for diagnosis, but angiographically occult DAVF is not uncommon. A 67-year-old man presented with a 2-year history of progressive paraparesis. Magnetic resonance (MR) imaging demonstrated segmental atrophy of the spinal cord and dilated coronary veins on the dorsal surface of the spinal cord. A DAVF was suspected, but repeated selective angiography failed to demonstrate the fistula. Findings from spoiled gradient echo MR imaging suggested that the draining vein flowed into the dilated venous plexus at the T-9 level. Selective computed tomography (CT) angiography of the right T-9 intercostal artery confirmed the location of the fistula. The authors successfully occluded the draining vein through surgery, and they observed that the fistula was low flow. The patient exhibited improvement in his symptoms, and postoperative MR imaging confirmed closure of the fistula. Selective CT angiography is useful in locating the draining vein of angiographically occult DAVF and therefore minimizing the extent of the surgical procedure.

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Computed tomography (CT) angiography with multidetector row helical CT for detecting spinal dural arteriovenous fistula

Rinsho Shinkeigaku ◽

10.5692/clinicalneurol.48.205 ◽

2008 ◽

Vol 48 (3) ◽

pp. 205-207 ◽

Cited By ~ 1

Author(s):

Hiroshi Kobessho ◽

Shigeru Mitsui ◽

Hiroyuki Ishihara ◽

Masahiko Fujii ◽

Ryota Kawasaki ◽

...

Keyword(s):

Computed Tomography ◽

Arteriovenous Fistula ◽

Ct Angiography ◽

Dural Arteriovenous Fistula ◽

Helical Ct ◽

Spinal Dural Arteriovenous Fistula ◽

Multidetector Row

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Engorged medullary vein on CT angiography in patients with dural arteriovenous fistula: prevalence, types, and comparison between regional and extensive types

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2017-013660 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1114-1119

Author(s):

Yen-Heng Lin ◽

Chung-Wei Lee ◽

Yu-Fen Wang ◽

Chi-Ju Lu ◽

Ya-Fang Chen ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Ct Angiography ◽

Cerebral Hemisphere ◽

Dural Arteriovenous Fistula ◽

Clinical Presentation ◽

Demographic Data ◽

Descriptive Analysis ◽

Clinical Information ◽

Clinical Findings ◽

Cerebral White Matter

Background and purposeEngorged medullary vein (EMV) in patients with intracranial dural arteriovenous fistula (DAVF) suggests venous congestion. The aim of this study is to investigate its prevalence, pattern, and correlation with clinical findings.Materials and methodsCT angiography (CTA) raw data of DAVF were used for multiplanar reconstruction and then analyzed for the presence and pattern of EMV, which is defined as a dilated vein in the cerebral white matter. Patients with EMV were divided into two groups: regional and extensive. Regional type is defined as EMV limited to one cerebral hemisphere or cerebellum without evidence of subcortical calcification. Extensive type is defined as EMV involvement of more than one cerebral hemisphere or both the cerebrum and cerebellum. Descriptive analysis of clinical information, DAVF characteristics, and other imaging findings was conducted. Clinical information, including demographic data, clinical presentation, and hemorrhage, were correlated with both types of EMV.ResultsAmong 192 eligible patients with DAVF, 71 (37%) had EMV. Patients with EMV were older (63 years vs 56 years, P=0.02), with DAVF more often at the transverse and sigmoid sinus (P<0.001), and more often presented with aggressive symptoms (59% vs 34%, P=0.02) than non-EMV patients, but there was no difference in the presentation of hemorrhage (15% vs 16%, P=0.99). Patients with regional EMV had a higher proportion of hemorrhage than those with the extensive type (24% vs 0%, P=0.006).ConclusionsEMV in patients with DAVF is associated with an aggressive manifestation. Regional type EMV is associated with a higher risk of a hemorrhagic presentation.

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CT Angiography in Patients with Peripheral Arterial Disease

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i2.28655 ◽

2020 ◽

Vol 16 (2) ◽

pp. 78-82

Author(s):

Pramod Kumar Chhetri ◽

Kripesh Thapa

Keyword(s):

Peripheral Arterial Disease ◽

Ct Angiography ◽

Imaging Modality ◽

Arterial Disease ◽

Medical Sciences ◽

Elderly Male ◽

Non Invasive ◽

History Of ◽

Peripheral Arterial

Background: Peripheral arterial disease is one of the most important causes of morbidity. Non-invasive characterization of peripheral arterial disease is possible by using CT angiography. The aim of this research is to evaluate CT angiographic findings in patients with peripheral arterial disease, to characterize lesion, risk factors and site of lesion. Methods: This hospital based prospective study was conducted in 40 consecutive patients with lower limb peripheral arterial disease who underwent CT angiography in the Department of Radiodiagnosis College of Medical Sciences-Teaching Hospital from January 2018 to Jan 2019. Results: Atherosclerotic peripheral disease was most common in elderly male patient with history of smoking, hypertension, diabetes or dyslipidemia and usually presents in the late stages with single or multiple arterial segmental involvement including the abdominal aorta. However, non- atherosclerosis peripheral arterial disease was seen in younger patients and presents with vascular thrombosis. Conclusions: CT angiography is a reliable non-invasive imaging modality for evaluating patients with peripheral arterial disease and lesion characterization. Keywords: CTA; Peripheral arterial disease.

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