Natural history, angiographic presentation and outcomes of anterior cranial fossa dural arteriovenous fistulas
| العنوان: | Natural history, angiographic presentation and outcomes of anterior cranial fossa dural arteriovenous fistulas |
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| المؤلفون: | Sebastian Sanchez, Ashrita Raghuram, Linder Wendt, Minako Hayakawa, Ching-Jen Chen, Jason P Sheehan, Louis J Kim, Isaac Josh Abecassis, Michael R Levitt, R Michael Meyer, Ridhima Guniganti, Akash P Kansagra, Giuseppe Lanzino, Enrico Giordan, Waleed Brinjikji, Diederik O Bulters, Andrew Durnford, W Christopher Fox, Jessica Smith, Adam J Polifka, Bradley Gross, Sepideh Amin-Hanjani, Ali Alaraj, Amanda Kwasnicki, Robert M Starke, Stephanie H Chen, J Marc C van Dijk, Adriaan R E Potgieser, Junichiro Satomi, Yoshiteru Tada, Ryan Phelps, Adib Abla, Ethan Winkler, Rose Du, Pui Man Rosalind Lai, Gregory J Zipfel, Colin Derdeyn, Edgar A Samaniego |
| المصدر: | Journal of NeuroInterventional Surgery. :neurintsurg-2022 |
| بيانات النشر: | BMJ, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Surgery, Neurology (clinical), General Medicine |
| الوصف: | BackgroundAnterior cranial fossa dural arteriovenous fistulas (ACF-dAVFs) are aggressive vascular lesions. The pattern of venous drainage is the most important determinant of symptoms. Due to the absence of a venous sinus in the anterior cranial fossa, most ACF-dAVFs have some degree of drainage through small cortical veins. We describe the natural history, angiographic presentation and outcomes of the largest cohort of ACF-dAVFs.MethodsThe CONDOR consortium includes data from 12 international centers. Patients included in the study were diagnosed with an arteriovenous fistula between 1990–2017. ACF-dAVFs were selected from a cohort of 1077 arteriovenous fistulas. The presentation, angioarchitecture and treatment outcomes of ACF-dAVF were extracted and analyzed.Results60 ACF-dAVFs were included in the analysis. Most ACF-dAVFs were symptomatic (38/60, 63%). The most common symptomatic presentation was intracranial hemorrhage (22/38, 57%). Most ACF-dAVFs drained through cortical veins (85%, 51/60), which in most instances drained into the superior sagittal sinus (63%, 32/51). The presence of cortical venous drainage predicted symptomatic presentation (OR 9.4, CI 1.98 to 69.1, p=0.01). Microsurgery was the most effective modality of treatment. 56% (19/34) of symptomatic patients who were treated had complete resolution of symptoms. Improvement of symptoms was not observed in untreated symptomatic ACF-dAVFs.ConclusionMost ACF-dAVFs have a symptomatic presentation. Drainage through cortical veins is a key angiographic feature of ACF-dAVFs that accounts for their malignant course. Microsurgery is the most effective treatment. Due to the high risk of bleeding, closure of ACF-dAVFs is indicated regardless of presentation. |
| تدمد: | 1759-8486 1759-8478 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6a812d6ba9c6706983e21455ca19f5a4 https://doi.org/10.1136/jnis-2022-019160 |
| رقم الأكسشن: | edsair.doi.dedup.....6a812d6ba9c6706983e21455ca19f5a4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17598486 17598478 |
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