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Initial results of endovascular intervention of brain dural arteriovenous fistula in cho ray hospital
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Abstract
Purpose: Brain dural arteriovenous fistula are fistulas
connecting the branches of dural arteries to dural veins or a venous
sinus at brain. Annually, the risk of cerebral hemorrhagic stroke
are 10,5%, increases the risk of intracranial hemorrhage due to
retrograde cortical venous drainage . Risk of hemorrhage up to
69% of patients occurred in either anterior cranial fossa or tentorial
lesions. Currently, treatments may such as surgery, gamma knife
but most clinicians consider endovascular treatment to be the
method of first choice. The purpose of this study was to assess the
efficacy and safety of endovascular intervention for the treatment of
brain dural arteriovenous fistula.
Materials and methods: All the patient treated by endovascular
intervention for the treatment of brain dural arteriovenous fistula at
Cho Ray hospital from June 2015 to May 2016. The techniques
for treatment of brain dural arteriovenous fistula include cerebral
angiography diagnosis, transarterial and/or transvenous approach,
microcatheter had reached the fistula point, embolization was
performed with coils, onyx, n-BCA glue. The efficacy and safety
were evaluated by variants: complete occlusion, procedure success
rate, clinical improvement, complicated procedure.
Results: There are 31 patients treated by endovascular
intervention. The technical success rates with complete obliteration
by transvenous approach are 88,4% (23/26) patients, technical
success rates with complete obliteration by transarterial approach
are 80% (4/5) patients, complete obliteration by combine transarterial
and transvenous approach 66,7% (2/3) patients, technical failure
6,4% (2/31) patients. After 1 month follow-up, mortality rate (0%),
hemorrhagic stroke (3,2%), vomiting and headache (9,6).
Conclusions: Endovascular intervention of brain dural
arteriovenous fisula is a safe and effective procedure.
Article Details
Keywords
Brain dural arteriovenous fistula, Cognard classification, complete obliteration, endovascular intervention
References
1. Borden Jonathan A (1995). A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment.Journal of Neurosurgery.82 (2).
2. Cheng KM, Chan ML, Cheung YL, et al (2003). Transvenous embolisation of dural carotid-cavernous fistulas by multiple venous routes: a series of 27 cases.Neurochirurgica.145 (1).
3. Cognard C, Gobin P, Pierol L et al (2010). Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Journal of Neurosurgery, 58, 62-68.
4. Cognard C, Januel A C, et al (2010). Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas with
Cortical Venous Drainage: New Management Using Onyx. Neuroradiol.
5. Jae Sang Oh, Seok Mann, Hyok Jin Oh, et al (2016). Endovascular Treatment of Dural Arteriovenous Fistulas:
Single Center Experience. Neurosurg, 59, 17-25.
6. Julius Griauzde,Joseph J Gemmete, Aditya S Pandey, Neeraj Chaudhary (2016). Dural carotid cavernous
fistulas: endovascular treatment and assessment of the correlation between clinical symptoms and the Cognard
classification system. J NeuroIntervent, 10.
7. Panagiotis Zogopoulos, Hajime Nakamura, Tomohiko Ozaki, et al (2015). Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas -Clinical and Radiographic Outcome Over A Long-Term Follow-Up. J Neurol Neurosurg.1(1).
8. Saraf R, Shrivastara M, Siddhathar W, et al (2010). Endovascular Treatment of Dural Arteriovenous Fistulas:
Single Center Experience. Neuro India, 58, 62-68.
9. Venturi C,Bracco S, Cerase A, et al (2003). Endovascular treatment of a cavernous sinus dural arteriovenous
fistula by transvenous embolisation through the superior ophthalmic vein via cannulation of a frontal vein. Neuroradiology.45 (8).