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Initial results of endovascular embolization for treatment of intracranial dural arteriovenous fistulas at Cho Ray Hospital
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Abstract
Objectives: Brain dural arteriovenous fistulas are connections of the branches of dural arteries to dural veins or a venous sinus at brain. Annually, the risk of cerebral hemorrhagic stroke is 10.5%, increasing the risk of intracranial hemorrhage due to retrograde cortical venous drainage. Currently, treatment options include surgery, gamma knife, and endovascular intervention, 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.
Subjets and methods: All the patients treated by endovascular intervention for the treatment of brain dural arteriovenous fistula at Cho Ray hospital from June 2015 to January 2017. The techniques for treatment include transarterial and/ or transvenous approach, microcatheter was inserted and reached the fistula point, embolization was performed with material agent such as: coils, n-BCA, PVA ... The efficacy and safety were evaluated by variants: complete, partial embolization, procedural success rate, clinical improvement, procedural complications.
Results: 52 patients treated by endovascular intervention. The technical success rates with complete obliteration by transvenous approach are 76.9% (30/39) patients, technical success rates with complete obliteration by transarterial approach are 66.7% (4/6) patients, complete obliteration by combined transarterial and transvenous approach 6/7 (85.7%) patients, mortality rate 1/52 (1.9%), hemorrhagic stroke 3/52 (5.7%), vomiting and headache 4/52 (7.8%).
Conclusions: Endovascular intervention of brain dural arteriovenous fistulas is a safe and effective procedure.
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Keywords
Brain dural arteriovenous fistulas, Cognard classification\, endovascular intervention, embolization
References
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