Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula

Özpeynirci, Yiğit; Trumm, Christoph; Stahl, Robert; Fischer, David; Liebig, Thomas; Forbrig, Robert

doi:10.1007/s00062-021-01130-1

Cited by 8 publications

(5 citation statements)

References 15 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The LD protocol yielded a dose reduction of 32.6%. The positive impact of this dedicated DSA protocol on radiation dose was also demonstrated in recently published papers from our institution [ 13 , 14 , 15 ].…”

Section: Discussionsupporting

confidence: 54%

“…Regarding neuroendovascular procedures, the current national guidelines for radiation protection, updated in 2018 [ 11 ], define national DRLs only for mechanical thrombectomy and embolization of an intracranial aneurysm [ 12 ]. In recent publications of our research group, local DRLs for endovascular treatment of unruptured intracranial aneurysms and intracranial lateral dural arteriovenous fistulas (DAVF), as well as for diagnostic angiographies in patients with spinal DAVFs, were defined [ 13 , 14 , 15 ] in order to expand the neuroendovascular DRL collection. In the current monocentric study, detailed dosimetrics in CCF patients treated by fluoroscopically-guided coil embolization are presented and compared between patients with direct and indirect CCFs, as well as between various DSA acquisition protocols.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Radiation Dose and Fluoroscopy Time of Endovascular Coil Embolization in Patients with Carotid Cavernous Fistulas

et al. 2022

Self Cite

View full text Add to dashboard Cite

Carotid cavernous fistulas (CCFs) are abnormal connections between the cavernous sinus and the internal and/or external carotid artery. Endovascular therapy is the gold standard treatment. In the current retrospective single-center study we report detailed dosimetrics of all patients with CCFs treated by endovascular coil embolization between January 2012 and August 2021. Procedural and dosimetric data were compared between direct and indirect fistulas according to Barrow et al., and different DSA protocol groups. The local diagnostic reference level (DRL) was defined as the 3rd quartile of the dose distribution. In total, thirty patients met the study criteria. The local DRL was 376.2 Gy cm2. The procedural dose area product (DAP) (p = 0.03) and the number of implanted coils (p = 0.02) were significantly lower in direct fistulas. The median values for fluoroscopy time (FT) (p = 0.08) and number of DSA acquisitions (p = 0.84) were not significantly different between groups. There was a significantly positive correlation between DAP and FT (p = 0.003). The application of a dedicated low-dose protocol yielded a 32.6% DAP reduction. In conclusion, this study provides novel DRLs for endovascular CCF treatment using detachable coils. The data presented in this work might be used to establish new specific DRLs.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Radiation Dose and Fluoroscopy Time of Endovascular Coil Embolization in Patients with Carotid Cavernous Fistulas

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…This is an invasive procedure that requires sedation, radiation, and contrast exposure, and carries risks for procedure-related complications. 21 Due to the low incidence of SDAVF, a large majority of diagnostic DSA is unremarkable, subjecting patients to unnecessary risks. 21 In addition, if catheterization of a spinal level is missed, accurate diagnosis may not occur.…”

Section: Discussionmentioning

confidence: 99%

“…21 Due to the low incidence of SDAVF, a large majority of diagnostic DSA is unremarkable, subjecting patients to unnecessary risks. 21 In addition, if catheterization of a spinal level is missed, accurate diagnosis may not occur. Oldfield et al presented a case series of 3 symptomatic patients in whom MRI and/or myelography findings were suggestive of SDAVF; however, DSA demonstrated no such results.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the diagnostic accuracy of 3D contrast-enhanced magnetic resonance angiography versus digital subtraction angiography in spinal dural arteriovenous fistulas

Khalafallah,

Yunga Tigre,

Rady

et al. 2024

Neurosurgical Focus

View full text Add to dashboard Cite

OBJECTIVE Spinal dural arteriovenous fistulas (SDAVFs) often go undiagnosed, leading to irreversible spinal cord dysfunction. Although digital subtraction angiography (DSA) is the gold standard for diagnosing SDAVF, DSA is invasive and operator dependent, with associated risks. MR angiography (MRA) is a promising alternative. This study aimed to evaluate the performance of MRA as an equal alternative to DSA in investigating, diagnosing, and localizing SDAVF. METHODS Prospectively collected data from a single neurosurgeon at a large tertiary academic center were searched for SDAVFs. Eligibility criteria included any patient with a surgically proven SDAVF in whom preoperative DSA, MRA, or both had been obtained. The eligible patients formed a consecutive series, in which they were divided into DSA and MRA groups. DSA and MRA were the index tests that were compared to the surgical SDAVF outcome, which was the reference standard. Accurate diagnosis was considered to have occurred when the imaging report matched the operative diagnosis to the correct spinal level. Comparisons used a two-sample t-test for continuous variables and Fisher-Freeman-Halton’s exact test for categorical variables, with p < 0.05 specifying significance. Univariate, bivariate, and multivariate analyses were conducted to investigate group associations with DSA and MRA accuracy. Positive predictive value, sensitivity, and accuracy were calculated. RESULTS A total of 27 patients with a mean age of 63 years underwent surgery for SDAVF. There were 19 male (70.4%) and 8 female (29.6%) patients, and the mean duration of symptoms at the time of surgery was 14 months (range 2–48 months). Seventeen patients (63%) presented with bowel or bladder incontinence. Bivariate analysis of the DSA and MRA groups further revealed no significant relationships between the characteristics and accuracy of SDAVF diagnosis. MRA was found to be more sensitive and accurate (100% and 73.3%) than DSA (85.7% and 69.2%), with a subanalysis of the patients with both preoperative MRA and DSA showing that MRA had a greater positive predictive value (78.6 vs 72.7), sensitivity (100 vs 72.7), and accuracy (78.6 vs 57.1) than DSA. CONCLUSIONS In surgically proven cases of SDAVFs, the authors determined that MRA was more accurate than DSA for SDAVF diagnosis and localization to the corresponding vertebral level. Incomplete catheterization at each vertebral level may result in the failure of DSA to detect SDAVF.

show abstract

“…13,14 The disadvantages of DSA are well known. It is an invasive technique with a small risk of major complications (< 1% of permanent neurologic deficits 15 ), exposing the patient to significant amounts of ionizing radiation, 16 especially in cases warranting catheterization of all feeding arteries from cranial to sacral levels, and it requires an expert to perform it.…”

Section: Imaging Techniques For Evaluating the Vascular Anatomy Of Th...mentioning

confidence: 99%

What the Musculoskeletal Radiologist Needs to Know About the Vascular Anatomy of the Spine and Spinal Cord

Duarte Armindo,

Vilela

2023

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

This article describes the vascular anatomy of the spine and spinal cord, highlighting key structures and anatomical variations relevant to musculoskeletal radiologists. It covers the arterial and venous drainage systems, along with examples of vascular conditions affecting the spine. Understanding the vascular anatomy of the spine and spinal cord is crucial for accurate interpretation of imaging studies and safe spinal interventional procedures. Imaging techniques for evaluating vascular pathology of the spine are discussed and compared. Understanding vascular anatomy and the most common vascular disorders will lead to an accurate diagnosis and suggest the appropriate type of study needed for further characterization and/or patient management.

show abstract

Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula

Cited by 8 publications

References 15 publications

Radiation Dose and Fluoroscopy Time of Endovascular Coil Embolization in Patients with Carotid Cavernous Fistulas

Radiation Dose and Fluoroscopy Time of Endovascular Coil Embolization in Patients with Carotid Cavernous Fistulas

Evaluating the diagnostic accuracy of 3D contrast-enhanced magnetic resonance angiography versus digital subtraction angiography in spinal dural arteriovenous fistulas

What the Musculoskeletal Radiologist Needs to Know About the Vascular Anatomy of the Spine and Spinal Cord

Contact Info

Product

Resources

About