Publication year: 2012
Source: World Neurosurgery, Available online 31 January 2012
George M. Ghobrial, Edward Marchan, Anil K. Nair, Aaron S. Dumont, Stavropoula I. Tjoumakaris, ...
ObjectivesDural arteriovenous fistulas (DAVFs) are arteriovenous shunts from a dural arterial supply to a dural venous channel, typically supplied by pachymeningeal arteries and located near a major venous sinus. A retrospective review was conducted to present the results of endovascular obliteration of DAVFs, with particular emphasis of newer liquid embolic agents, including ONYX-18 (MV3, Irvine, CA).MethodsA review of the literature was performed and a presentation of the number of treatments, complications, and outcomes.(48, 64, 67, 73) The number of arterial embolizations and need for transvenous embolization, open surgery, and radiosurgery was assessed as well as normalization of retrograde cortical venous drainage (CVD).ResultsThirty-nine patients (22 males and 17 females) underwent endovascular treatment of DAVFs at our institution from 2001-2009. Ages ranged from 39-71 (mean 48). Seventy-nine percent of patients had retrograde cortical venous drainage. The average number of embolizations in all patients was 2.1. Twelve patients underwent 40 embolization treatments with Onyx with an obliteration rate of 75% and CVD obliteration rate of 85%. Seventy-one percent (28/39) of patients had complete treatment of the fistula: 21 by purely endovascular treatment and 7 with endovascular therapy followed by craniotomy As well as seven patients who underwent stereotactic radiosurgery after embolization.ConclusionsEndovascular management of DAVFs is a safe and effective method of treating these complex lesions.
Júlio Leonardo B. Pereira
No comments:
Post a Comment