PT  - JOURNAL ARTICLE
AU  - Duan, Guoli
AU  - Zhang, Yuhang
AU  - Wang, Yang
AU  - Li, Zhe
AU  - Shang, Chenghao
AU  - Chen, Rundong
AU  - Zhao, Rui
AU  - Yang, Pengfei
AU  - Dai, Dongwei
AU  - Fang, Yibin
AU  - Huang, Qinghai
AU  - Hong, Bo
AU  - Xu, Yi
AU  - Li, Qiang
AU  - Liu, Jianmin
TI  - Low-and intermediate-grade lateral sinus dural arterio venous fistulas: Factors affecting the outcome of endo vascular treatment over 18-year experience in a high-volume neurovascular center
AID  - 10.3174/ajnr.A8622
DP  - 2024 Dec 13
TA  - American Journal of Neuroradiology
PG  - ajnr.A8622
4099  - http://www.ajnr.org/content/early/2024/12/13/ajnr.A8622.short
4100  - http://www.ajnr.org/content/early/2024/12/13/ajnr.A8622.full
AB  - BACKGROUND AND PURPOSE: Lateral sinus dural arteriovenous fistulas (LS-DAVFs) carry a higher rate of recurrence after endovascular treatment (EVT). Our objective was to investigate the independent predictors of recurrence and unfavorable functional outcome of low-and intermediate-grade LS-DAVFs after EVT.MATERIALS AND METHODS: Retrospectively reviewed our database of prospectively collected information for all patients with low and intermediate-grade LS-DAVFs that underwent EVT from May 2004 to December 2021. Patient demographic, angiographic, treatment, and outcome were analyzed to identify independent predictors of recurrence and unfavorable outcome.RESULTS: One hundred and seventeen patients with 117 low-and intermediate-grade LS-DAVFs underwent EVT were included in this study. The mean age of the patients was 53.0±17.5 years. Immediately complete obliteration was achieved in 103/117 (88%) patients after EVT. Clinical follow-up were available for all of 117 patients, with an unfavorable outcome rate of 5.1%. Angiographic follow-up was available in 91 patients (78%). Recurrence occurred in 16 (18%) patients and 8 (6.8%) received retreatment. Contralateral sinus severe stenosis or occlusion was an independent high-risk factor for the unfavorable outcome (OR=11.7; 95% CI: 1.9-70.9, P<0.01) and recurrence (OR=63.8; 95% CI: 10.3-396.5, P<0.01) for low-and intermediate-grade LS-DAVFs at follow-up.CONCLUSIONS: Contralateral sinus severe stenosis or occlusion represents a stronger independent risk factor associated with recurrence and unfavorable outcome in patients with low-and intermediate-grade LS-DAVFs when the involved ipsilateral sinus was occluded after EVT. For patients with LS-DAVFs, the patency of the contralateral sinus should be considered when therapeutic decision-making.ABBREVIATIONS: LS-DAVFs = Lateral sinus dural arteriovenous fistulas; EVT = endovascular treatment; TAE = Transarterial Embolization; TVE = Transvenous Embolization; CN = cranial nerve; CVD = cortical venous drainage.