Spinal dural arteriovenous fistulas: Long-term follow-up of 44 treated patients

Neurology ◽  
2004 ◽  
Vol 62 (10) ◽  
pp. 1839-1841 ◽  
Author(s):  
K. Jellema ◽  
C. C. Tijssen ◽  
W. J.J. van Rooij ◽  
M. Sluzewski ◽  
P. J. Koudstaal ◽  
...  
Keyword(s):  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Long Term Follow Up ◽  
Spinal Dural Arteriovenous Fistulas

scholarly journals Transarterial Onyx Embolization of Cranial Dural Arteriovenous Fistulas: Long-Term Follow-Up

2014 ◽  
Vol 35 (9) ◽  
pp. 1793-1797 ◽  
Author(s):  
R. V. Chandra ◽  
T. M. Leslie-Mazwi ◽  
B. P. Mehta ◽  
A. J. Yoo ◽  
J. D. Rabinov ◽  
...  
Keyword(s):  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Long Term Follow Up

scholarly journals Endovascular therapy of low- and intermediate-grade intracranial lateral dural arteriovenous fistulas: a detailed analysis of primary success rates, complication rates, and long-term follow-up of different technical approaches

2017 ◽  
Vol 126 (2) ◽  
pp. 360-367 ◽  
Author(s):  
Lorenz Ertl ◽  
Hartmut Brückmann ◽  
Mathias Kunz ◽  
Alexander Crispin ◽  
Gunther Fesl
Keyword(s):  
Complication Rate ◽  
Complication Rates ◽  
Success Rates ◽  
Intermediate Grade ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Primary Success ◽  
Long Term Follow Up

OBJECTIVE Sinus-preserving (SP) embolization techniques augment endovascular treatment options for intracranial lateral dural arteriovenous fistulas (DAVFs). The authors aimed to perform a retrospective comparison of their primary success rates, complication rates, and long-term follow-up with those of sinus-occluding (SO) treatment variants in the collective of low- and intermediate-grade lateral DAVFs (Cognard Types I–IIb). METHODS Clinical symptoms, complication rates, and Cognard grading prior to and after endovascular DAVF treatment using different technical approaches was retrospectively analyzed in 36 patients with lateral DAVF Cognard Types I–IIb. The long-term success rate was determined by a standardized questionnaire. RESULTS The SO approaches offered a higher rate of definitive fistula occlusion (93% SO vs 71% SP) but were accompanied by a significantly higher complication rate (33% or 20% SO vs 0% SP). The patients interviewed reported very high satisfaction with their health in long-term follow-up in both groups. CONCLUSIONS A higher rate of definitive fistula occlusion in the SO group was attained at the price of a significantly higher complication rate. The SP approaches offered a good primary success rate in combination with a very low complication rate. Despite some limitations of the data (e.g., a small sample size) the authors thus recommend an SP variant as the primary therapeutic option for the endovascular treatment of low- and intermediate-grade DAVFs. The SO approaches should be restricted to cases in which SP treatment does not achieve a downgrading to no worse than Cognard Type IIa.

Endovascular embolization of high-grade cerebral dural arteriovenous fistulas - assessment of long-term recurrences

2021 ◽  
pp. 159101992110382
Author(s):  
Alan Mendez-Ruiz ◽  
Waldo R Guerrero ◽  
Viktor Szeder ◽  
Mudassir Farooqui ◽  
Cynthia B Zevallos ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Dural Arteriovenous Fistula ◽  
High Flow ◽  
High Grade ◽  
Complete Occlusion ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Mean Time

Introduction Endovascular therapy has shown to be safe and effective for the treatment of cerebral dural arteriovenous fistulas; however, recurrence after complete occlusion is not uncommon, and the timing of recurrence remains unknown. Methods A retrospective single-center cohort study was conducted from January 2005 to December 2020. Patients with high-grade (≥Borden II–Cognard IIB) dural arteriovenous fistulas treated with endovascular therapy were included in this study. Clinical and angiographic characteristics were collected for hospitalization and at follow-up. Results A total of 51 patients with a median age of 61 years were studied; 57% were female. High-flow symptoms related to the high-flow fistula were the most common presentation (67%), and 24% presented with intracranial hemorrhage. Transverse-sigmoid (26%) and cavernous (26%) sinuses were the most common dural arteriovenous fistula locations. A total of 40 patients (70%) had middle meningeal arterial feeders and 4 (7%) had deep cerebral venous drainage. The mean number of embolization procedures per patient was 1.4. Transarterial access was the most frequent approach (61%). Onyx alone was the most common embolic agent (26%). Complete occlusion rate was achieved in 46 patients (80.1%). Last mean radiographic follow-up time was 26.7 months for all 57 dural arteriovenous fistulas. Dural arteriovenous fistula recurrence after radiographic resolution at last treatment was seen in six cases (6/46, 13.1%). Mean time for recurrence was 15.8 months. Mean time of last clinical follow-up was 46.1 months for the 51 patients (100%). A total of 10 (20%) experienced any procedural complications, among which two (4%) became major thromboembolic events. Conclusion Endovascular therapy is safe and effective for the treatment of high-grade dural arteriovenous fistulas. Given the significant recurrence rate of embolized dural arteriovenous fistulas even after 2 years, long-term angiographic follow-up might be needed.

A single-center, long-term study of spinal dural arteriovenous fistulas with multidisciplinary treatment

2011 ◽  
Vol 18 (12) ◽  
pp. 1662-1666 ◽  
Author(s):  
Fernando Ruiz-Juretschke ◽  
Jose M. Perez-Calvo ◽  
Enrique Castro ◽  
Roberto García-Leal ◽  
Olga Mateo-Sierra ◽  
...  
Keyword(s):  
Multidisciplinary Treatment ◽  
Single Center ◽  
Term Study ◽  
Arteriovenous Fistulas ◽  
Long Term Study ◽  
Dural Arteriovenous Fistulas ◽  
Spinal Dural Arteriovenous Fistulas

Surgical and endovascular treatment of spinal dural arteriovenous fistulas: long-term disability assessment and prognostic factors

2001 ◽  
Vol 94 (2) ◽  
pp. 199-204 ◽  
Author(s):  
Joon K. Song ◽  
Fernando Viñuela ◽  
Y. Pierre Gobin ◽  
Gary R. Duckwiler ◽  
Yuichi Murayama ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mr Imaging ◽  
Symptom Onset ◽  
Disability Score ◽  
Content Type ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Spinal Dural Arteriovenous Fistulas ◽  
Fine Print

Object. The authors assessed clinical outcomes of patients with treated spinal dural arteriovenous fistulas (DAVFs) and investigated prognostic factors. Methods. Thirty consecutive patients with spinal DAVFs were treated at the authors' institution during the past 15 years: seven underwent surgery; seven underwent surgery after failed embolization; and 16 underwent embolization alone. The outcomes of gait and micturition disability were analyzed. Follow up averaged 3.4 years (range 1 month–11.8 years). Age, duration of symptoms, pre- and postintervention magnetic resonance (MR) imaging findings, and preintervention disability were correlated with outcome. Seventeen patients (57%) experienced improved gait, 12 (40%) were unchanged, and one (3%) was worse. In 11 patients (37%) micturition function was improved, in 15 (50%) it was unchanged, and in four (13%) it was worse. Gait disability, as measured by the Aminoff—Logue Scale, was significantly improved after treatment, from 3.4 ± 1.4 (average ± standard deviation) to 2.7 ± 1.5 (p = 0.007). Mean micturition disability scores decreased, but not significantly, from 1.9 ± 1 to 1.6 ± 1.1 (p = 0.20). Preintervention gait disability was not associated with improvement except for patients with Aminoff—Logue Scale Grade 4 disability (eight of nine improved; p = 0.024). For patients treated within 13 months of symptom onset, mean micturition disability decreased (p = 0.035). No association was found between clinical improvement and age, a symptom duration less than 30 months, or pre- and postintervention MR imaging—documented spinal cord edema. Conclusions. Spinal DAVF treatment significantly improved patients' mean gait disability score by almost one grade at last follow up. The mean micturition disability score was not significantly improved, unless treatment was performed within 13 months of symptom onset. Longer and more uniform follow-up study is needed to determine if improved and stabilized clinical outcomes are sustained.

scholarly journals Microscope-assisted endoscopic interlaminar ligation of spinal arteriovenous fistulas: technical note

2016 ◽  
Vol 25 (3) ◽  
pp. 394-397 ◽  
Author(s):  
Chen Wang ◽  
Chien-Min Chen ◽  
Fang Shen ◽  
Xiao-Dong Fang ◽  
Guang-Yu Ying ◽  
...  
Keyword(s):  
Technical Note ◽  
Endoscopic Management ◽  
Short Term ◽  
Endoscopic Techniques ◽  
Arteriovenous Fistulas ◽  
Interlaminar Approach ◽  
Dural Arteriovenous Fistulas ◽  
Spinal Arteriovenous Malformations ◽  
Spinal Dural Arteriovenous Fistulas

Spinal dural arteriovenous fistulas (SDAVFs) are the most common type of spinal arteriovenous malformations, and microsurgical ligation is the treatment modality most frequently used for these lesions. Developments in endoscopic techniques have made endoscopy an even less invasive alternative to routine microsurgical approaches in spine surgery, but endoscopic management of SDAVF or other intradural spinal lesions has not been reported to date. The authors describe the use of a microscope-assisted endoscopic interlaminar approach for the ligation of the proximal draining vein of an L-1 SDAVF in a 58-year-old man. A complete cure was confirmed by postoperative angiography. The postoperative course was uneventful, and short-term follow-up showed improvements in the patient's neurological function. The authors conclude that the endoscopic interlaminar approach with microscope assistance is a safe, minimally invasive, innovative technique for the surgical management of SDAVFs in selected patients.

Sign in / Sign up

Export Citation Format

Share Document