Universität zu Köln

Maus, Volker, Drescher, Finn, Goertz, Lukas, Weber, Anushe, Weber, Werner and Fischer, Sebastian (2020). Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas: A German Single-Center Experience. Cerebrovasc. Dis. Extra, 10 (2). S. 84 - 94. BASEL: KARGER. ISSN 1664-5456

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Abstract

Background and Purpose:Intracranial dural arteriovenous fistulas (DAVFs) are abnormal shunts between dural arteries and dural venous sinus or cortical veins. We report our experience with endovascular therapy of primary complex DAVFs using modern embolic agents.Methods:This is a retrospective analysis of patients with DAVFs treated between 2015 and 2019. Patient demographics and technical aspects including the use of embolic agent, access to the fistula, number of treatments, occlusion rates, and complications were addressed. Angiographic treatment success was defined as complete occlusion (CO) of the DAVF.Results:Fifty patients were treated endovascularly. Median age was 61 years and 66% were men. The most common symptom was pulsatile tinnitus in 17 patients (34%). The most frequent location of the DAVF was the transverse-sigmoid sinus (40%). Thirty-six fistulas (72%) had cortical venous reflux. Nonadhesive and adhesive liquid agents were used in 92% as a single material or in combination. CO was achieved in 48 patients (96%). In 28 individuals (56%), only 1 procedure was necessary. Nonadhesive liquid agents were exclusively used in 14 patients (28%) with CO attained in every case. For CO of tentorial DAVFs, multiple sessions were more often required than at the other locations (55 vs. 14%,p= 0.0051). Among 93 procedures, the overall complication rate was 3%. The procedure-related mortality rate was 0%.Conclusion:Endovascular treatment of intracranial DAVFs is feasible, safe, and effective with high rates of CO. In more than half of the patients, the DAVF was completely occluded after a single procedure. However, in tentorial DAVFs, multiple sessions were more often required.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Drescher, Finn UNSPECIFIED UNSPECIFIED UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Anushe UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Werner UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-350025
DOI:	10.1159/000509455
Journal or Publication Title:	Cerebrovasc. Dis. Extra
Volume:	10
Number:	2
Page Range:	S. 84 - 94
Date:	2020
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1664-5456
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SIGMOID SINUS; MANAGEMENT; EMBOLIZATION; CLASSIFICATION; MALFORMATIONS; TRANSVERSE Multiple languages Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/35002