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Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of Endovascular Treatment

Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of... ORIGINAL RESEARCH INTERVENTIONAL Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of Endovascular Treatment X L. De´traz, X K. Orlov, X V. Berestov, X V. Borodetsky, X A. Rouchaud , X L.G. de Abreu Mattos, and X C. Mounayer ABSTRACT BACKGROUND AND PURPOSE: Dural AVFs located in the posterior fossa are a rare entity. The objectives of the study were to analyze the anatomy of dural AVFs, their endovascular treatment strategies, and clinical outcomes. MATERIALSANDMETHODS: TwocentersretrospectivelyselectedpatientstreatedbetweenJanuary2009andJune2018havingposterior fossa dural AVFs. We collected patient demographics, clinical presentation, arterial and venous outflow anatomy of the dural AVFs, and treatment outcomes. RESULTS: Twenty-sixpatientstreatedendovascularlyforposteriorfossaduralAVFs,typeIII,IV,orV,wereincluded.Onehundredpercent of the dural AVFs were occluded. A transarterial approach was performed in 23 dural AVFs (88.5%); a combined transarterial and trans- venous approach, for 2 dural AVFs (7.7%); and a transvenous approach alone, for 1 dural AVF (3.8%). The middle meningeal artery was the most common artery chosen to inject embolic liquid (46%, 12/26). Procedure-related morbidity was 15.4% at 24 hours, 7.7% at discharge, and 0% at 6 months. Procedure-related mortality was 0%. CONCLUSIONS: Endovascular treatment offers high occlusion rates for posterior fossa dural AVFs with low morbidity and mortality rates.Thearterialapproachisthefirst-linepreferredapproach,evenifatransvenousorcombinedapproachwouldbeasafeandeffective option for patients with favorable anatomy. ABBREVIATIONS: http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of Endovascular Treatment

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Publisher
American Journal of Neuroradiology
Copyright
© 2019 by American Journal of Neuroradiology
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A6140
Publisher site
See Article on Publisher Site

Abstract

ORIGINAL RESEARCH INTERVENTIONAL Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of Endovascular Treatment X L. De´traz, X K. Orlov, X V. Berestov, X V. Borodetsky, X A. Rouchaud , X L.G. de Abreu Mattos, and X C. Mounayer ABSTRACT BACKGROUND AND PURPOSE: Dural AVFs located in the posterior fossa are a rare entity. The objectives of the study were to analyze the anatomy of dural AVFs, their endovascular treatment strategies, and clinical outcomes. MATERIALSANDMETHODS: TwocentersretrospectivelyselectedpatientstreatedbetweenJanuary2009andJune2018havingposterior fossa dural AVFs. We collected patient demographics, clinical presentation, arterial and venous outflow anatomy of the dural AVFs, and treatment outcomes. RESULTS: Twenty-sixpatientstreatedendovascularlyforposteriorfossaduralAVFs,typeIII,IV,orV,wereincluded.Onehundredpercent of the dural AVFs were occluded. A transarterial approach was performed in 23 dural AVFs (88.5%); a combined transarterial and trans- venous approach, for 2 dural AVFs (7.7%); and a transvenous approach alone, for 1 dural AVF (3.8%). The middle meningeal artery was the most common artery chosen to inject embolic liquid (46%, 12/26). Procedure-related morbidity was 15.4% at 24 hours, 7.7% at discharge, and 0% at 6 months. Procedure-related mortality was 0%. CONCLUSIONS: Endovascular treatment offers high occlusion rates for posterior fossa dural AVFs with low morbidity and mortality rates.Thearterialapproachisthefirst-linepreferredapproach,evenifatransvenousorcombinedapproachwouldbeasafeandeffective option for patients with favorable anatomy. ABBREVIATIONS:

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Aug 1, 2019

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