Dural Arteriovenous Fistulas: A Review of the Literature and a Presentation of a Single Institution’s Experience

Ghobrial, George M.; Marchan, Edward M.; Nair, Anil K.; Dumont, Aaron S.; Tjoumakaris, Stavropoula; Gonzalez, L. Fernando; Rosenwasser, Robert H.; Jabbour, Pascal

doi:10.1016/j.wneu.2012.01.053

Cited by 50 publications

(37 citation statements)

References 37 publications

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“…In the last 5 to 10 years, however, there has been a paradigm shift toward transarterial embolization of dAVF. Contemporary series have consistently demonstrated cure rates with transarterial embolization exceeding 70%, results which mirror our findings (Hu et al, ; Maimon et al, ; Ghobrial et al, ; Chandra et al, ; Li et al, ; Miyamoto et al, ). The advent of Onyx has been credited for a higher probability for obliteration through a purely transarterial route (Hu et al, ).…”

Section: Discussionsupporting

confidence: 90%

Middle meningeal artery: Gateway for effective transarterial Onyx embolization of dural arteriovenous fistulas

Griessenauer

Salem

et al. 2016

Clinical Anatomy

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Curative transarterial embolization of noncavernous sinus dural arteriovenous fistulas (dAVFs) is challenging. We sought to evaluate the role of the middle meningeal artery (MMA) in endovascular treatment of these lesions. We performed a retrospective cohort study on patients who underwent transarterial Onyx embolization of a noncavernous sinus dAVFs with contribution from the MMA at a major academic institution in the United States from January 2009 to January 2015. Twenty consecutive patients who underwent transarterial Onyx embolization of a noncavernous sinus dAVF were identified. One patient was excluded as there was no MMA contribution to the dAVF. All of the remaining 19 patients (61.3 ± 13.8 years of age) underwent transarterial embolization through the MMA. Six patients (31.6%) presented with intraparenchymal or subarachnoid hemorrhage from the dAVF. The overall angiographic cure rate was 73.7% upon last follow up. In 71.4% of successfully treated patients transarterial embolization of the MMA alone was sufficient to achieve angiographic cure. When robust MMA supply was present, MMA embolization resulted in angiographic cure even after embolization of other arterial feeders had failed in 92.9% of patients. A robust contribution of the MMA to the fistula was the single most important predictor for successful embolization (P = 0.00129). We attribute our findings to the fairly straight, non-tortuous course of the MMA that facilitates microcatheter access, navigation, and Onyx penetration. Noncavernous sinus dAVF can be successfully embolized with transarterial Onyx through the MMA, as long as supply is robust. A transvenous approach is rarely necessary. Clin. Anat. 29:718-728, 2016. © 2016 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 90%

Middle meningeal artery: Gateway for effective transarterial Onyx embolization of dural arteriovenous fistulas

Griessenauer

Salem

et al. 2016

Clinical Anatomy

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“…DAVFs may take one of several natural courses: (1) some undergo spontaneous regression and involution, (2) others remain asymptomatic without angiographic changes, and (3) yet others exhibit progressive arterial or venous growth and become more aggressive, recruiting new pachymeningeal arterial feeders and pial venous drainage 5 6 18. In general, benign DAVFs are thought to be stable over time, with only 1–2% converting to aggressive forms 16.…”

Section: Discussionmentioning

confidence: 99%

“…The annual risk of hemorrhage or non-hemorrhagic neurological deficit for DAVFs with CVD is 8.1% and 6.9%, respectively,3 12 14 17 18 and rebleeding occurs in up to 35% of patients with hemorrhage 12. DAVFs thus require careful evaluation and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Endovascular embolization is considered the treatment of choice for the majority of DAVFs2 3 5 7–16 18–21 and a multitude of embolization materials have been used with varying success, including: detachable coils, n-butyl cyanoacrylate (NBCA), and Onyx (ev3, Irvine, California, USA). Early outcomes reported for Onyx embolization of DAVFs are encouraging,13 17 18 20 22–26 but evidence regarding the long term durability of DAVF Onyx embolization is lacking. In the current study, we present the immediate, mid term, and long term outcomes as well as complications and predictors of recurrence for a consecutive series of 63 intracranial DAVFs subjected to endovascular Onyx embolization.…”

Section: Introductionmentioning

confidence: 99%

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Mid and long term outcomes of dural arteriovenous fistula endovascular management with Onyx. Experience of a single tertiary center

Rangel-Castilla

Barber

Klucznik

et al. 2013

J NeuroIntervent Surg

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“…Aparentemente não há predileção por sexo, porém há estudos que sugerem uma leve preferência das FAVds pelo sexo masculino a uma taxa de 4:3 4,9,12 . A média de idade dos pacientes que apresentam sintomas é de 50-60 anos, sendo que a apresentação clínica da FAVd é determinada pela sua localização, padrão de drenagem e capacidade de compensação do ambiente peri-fístula 4,7,9,10,16 .…”

Section: Revisão De Literaturaunclassified

Fístula Arteriovenosa Dural Intracraniana

Aragão¹,

Merida²,

Leal³

et al. 2018

jbnc

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A fístula arteriovenosa dural (FAVd) é uma entidade clínica rara e de apresentação variada caracterizada por uma comunicação anômala entre artérias durais e seio venoso e/ou veias corticais. É responsável por 10-15% de todas as malformações vasculares intracranianas, cuja faixa etária mais acometida é dos 50-60 anos de idade, porém com variações dependendo do tipo de fístula. Neste trabalho os objetivos foram relatar dois casos clínicos de FAVd, um deles considerado “benigno” e outro “maligno” para ilustrar esta condição incomum (FAVd), bem como revisar a literatura com foco na epidemiologia, fisiopatologia, diagnóstico e tratamento desta patologia. A importância do conhecimento deste tema é de fundamental importância por parte do profissional médico, de modo a proporcionar um diagnóstico precoce e um tratamento eficaz.

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Dural Arteriovenous Fistulas: A Review of the Literature and a Presentation of a Single Institution’s Experience

Cited by 50 publications

References 37 publications

Middle meningeal artery: Gateway for effective transarterial Onyx embolization of dural arteriovenous fistulas

Middle meningeal artery: Gateway for effective transarterial Onyx embolization of dural arteriovenous fistulas

Mid and long term outcomes of dural arteriovenous fistula endovascular management with Onyx. Experience of a single tertiary center

Fístula Arteriovenosa Dural Intracraniana

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