Stereotactic Radiosurgery and Particulate Embolization for Cavernous Sinus Dural Arteriovenous Fistulae

Stereotactic Radiosurgery and Particulate Embolization for Cavernous Sinus Dural Arteriovenous... AbstractOBJECTIVE:To evaluate the safety and efficacy of stereotactic radiosurgery, either with or without transarterial J embolization, in the treatment of patients with dural arteriovenous fistulae (DAVFs) of the cavernous sinus.METHODS:We reviewed the findings, from a prospectively established database, for 20 patients with cavernous sinus DAVFs who were treated with either radiosurgery alone (n = 7) or radiosurgery and transarterial * embolization (n = 13) in a 7-year period. The median follow-up period after radiosurgery was 36 months (range, 4-59 mo).RESULTS:Nineteen of 20 patients (95%) experienced improvement of their clinical symptoms. Fourteen of 15 ;aj patients (93%) experienced either total (n = 13) or nearly total (n = 1) obliteration of their DAVFs, as documented by angiography performed a median of 12 months after radiosurgery. No patient experienced a ilk recurrence of symptoms after angiography showed DAVF obliteration. Two patients developed new neurological deficits after embolization procedures. One patient exhibited temporary aphasia secondary to a venous infarction; another patient exhibited permanent Vlth cranial nerve weakness related to acute cavernous sinus thrombosis. Two patients experienced recurrent symptoms and underwent repeat transarterial embolization at 7 and 12 months; both patients achieved clinical and angiographic cures (5 and 10 mo later, respectively). One patient experienced recurrent visual symptoms and underwent transvenous embolization 4 months after radiosurgery.CONCLUSION:Staged radiosurgery and transarterial embolization provided both rapid symptom relief and longterm cures for patients with cavernous sinus DAVFs. Radiosurgery alone was effective for patients with DAVFs whose arterial supply was not accessible via a transarterial approach, although the time course of symptom improvement was longer, compared with patients who also underwent embolization. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Stereotactic Radiosurgery and Particulate Embolization for Cavernous Sinus Dural Arteriovenous Fistulae

Stereotactic Radiosurgery and Particulate Embolization for Cavernous Sinus Dural Arteriovenous Fistulae

CLIN ICA L STUDIES Stereotactic Radiosurgery and Particulate Embolization for Cavernous Sinus Dural Arteriovenous Fistulae Bruce E. Pollock, M.D., Douglas A. Nichols, M.D., James A. Garrity, M.D., Deborah A. Gorman, R.N., Scott L. Stafford, M.D. Departments of Neurological Surgery (BEP, DAG), Diagnostic Radiology (DAN), Ophthalmology (JAG), and Radiation Oncology (SLS), M ayo Clinic and Foundation, Rochester, Minnesota OBJECTIVE: To evaluate the safety and efficacy of stereotactic radiosurgery, either with or without transarterial embolization, in the treatment of patients with dural arteriovenous fistulae (DAVFs) of the cavernous sinus. METHODS: W e reviewed the findings, from a prospectively established database, for 20 patients with cavernous sinus DAVFs who were treated with either radiosurgery alone (n = 7) or radiosurgery and transarterial * embolization (n = 13) in a 7-year period. The median follow-up period after radiosurgery was 36 months (range, 4-59 mo). ‘ RESULTS: Nineteen of 20 patients (9 5 % ) experienced improvement of their clinical symptoms. Fourteen of 15 ;a j patients (9 3 % ) experienced either total (n = 13) or nearly total (n = 1) obliteration of their DAVFs, as documented by angiography performed a median of 12 months after radiosurgery. No patient experienced a ilk recurrence of symptoms after angiography showed DAVF obliteration. Two patients developed new neurological | deficits after embolization procedures. One patient exhibited temporary aphasia secondary to a venous infarc­ tion; another patient exhibited permanent Vlth cranial nerve weakness related to acute cavernous sinus throm­ bosis. Two patients experienced recurrent symptoms and underwent repeat transarterial embolization at 7 and 12 months; both patients achieved clinical and angiographic cures (5 and 10 mo later, respectively). One patient experienced recurrent visual symptoms and underwent transvenous embolization 4 months after radiosurgery. CONCLUSION:...
Loading next page...
 
/lp/ou_press/stereotactic-radiosurgery-and-particulate-embolization-for-cavernous-zp0U8OCSRI
Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199909000-00008
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:To evaluate the safety and efficacy of stereotactic radiosurgery, either with or without transarterial J embolization, in the treatment of patients with dural arteriovenous fistulae (DAVFs) of the cavernous sinus.METHODS:We reviewed the findings, from a prospectively established database, for 20 patients with cavernous sinus DAVFs who were treated with either radiosurgery alone (n = 7) or radiosurgery and transarterial * embolization (n = 13) in a 7-year period. The median follow-up period after radiosurgery was 36 months (range, 4-59 mo).RESULTS:Nineteen of 20 patients (95%) experienced improvement of their clinical symptoms. Fourteen of 15 ;aj patients (93%) experienced either total (n = 13) or nearly total (n = 1) obliteration of their DAVFs, as documented by angiography performed a median of 12 months after radiosurgery. No patient experienced a ilk recurrence of symptoms after angiography showed DAVF obliteration. Two patients developed new neurological deficits after embolization procedures. One patient exhibited temporary aphasia secondary to a venous infarction; another patient exhibited permanent Vlth cranial nerve weakness related to acute cavernous sinus thrombosis. Two patients experienced recurrent symptoms and underwent repeat transarterial embolization at 7 and 12 months; both patients achieved clinical and angiographic cures (5 and 10 mo later, respectively). One patient experienced recurrent visual symptoms and underwent transvenous embolization 4 months after radiosurgery.CONCLUSION:Staged radiosurgery and transarterial embolization provided both rapid symptom relief and longterm cures for patients with cavernous sinus DAVFs. Radiosurgery alone was effective for patients with DAVFs whose arterial supply was not accessible via a transarterial approach, although the time course of symptom improvement was longer, compared with patients who also underwent embolization.

Journal

NeurosurgeryOxford University Press

Published: Sep 1, 1999

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off