RT Journal Article
SR Electronic
T1 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
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP ajnr.A8622
DO 10.3174/ajnr.A8622
A1 Duan, Guoli
A1 Zhang, Yuhang
A1 Wang, Yang
A1 Li, Zhe
A1 Shang, Chenghao
A1 Chen, Rundong
A1 Zhao, Rui
A1 Yang, Pengfei
A1 Dai, Dongwei
A1 Fang, Yibin
A1 Huang, Qinghai
A1 Hong, Bo
A1 Xu, Yi
A1 Li, Qiang
A1 Liu, Jianmin
YR 2024
UL http://www.ajnr.org/content/early/2024/12/13/ajnr.A8622.abstract
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.