Endovascular treatment of dural arteriovenous fistulas using transarterial liquid embolization in combination with transvenous balloon-assisted protection of the venous sinus

• Verfasst von: Vollherbst, Dominik [VerfasserIn]
• Verfasst von: Ulfert, Christian [VerfasserIn]
• Verfasst von: Neuberger, Ulf [VerfasserIn]
• Verfasst von: Herweh, Christian [VerfasserIn]
• Verfasst von: Laible, Mona [VerfasserIn]
• Verfasst von: Nagel, Simon [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Möhlenbruch, Markus Alfred [VerfasserIn]
• Titel: Endovascular treatment of dural arteriovenous fistulas using transarterial liquid embolization in combination with transvenous balloon-assisted protection of the venous sinus
• Verf.angabe: D.F. Vollherbst, C. Ulfert, U. Neuberger, C. Herweh, M. Laible, S. Nagel, M. Bendszus, and M.A. Möhlenbruch
• Jahr: 2018
• Umfang: 7 S.
• Fussnoten: Gesehen am 28.03.2019
• Titel Quelle: Enthalten in: American journal of neuroradiology
• Ort Quelle: Oak Brook, Ill. : Soc., 1980
• Jahr Quelle: 2018
• Band/Heft Quelle: 39(2018), 7, Seite 1296-1302
• ISSN Quelle: 1936-959X
• DOI: doi:10.3174/ajnr.A5651
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1662504489

Abstract

BACKGROUND AND PURPOSE: Sinus-preserving endovascular embolization was described as a promising treatment technique for dural arteriovenous fistulas. Our aim was to report our single-center experience in patients with dural arteriovenous fistulas who were treated with transarterial liquid embolization in combination with transvenous balloon-assisted protection of the affected venous sinus. - MATERIALS AND METHODS: A retrospective analysis of a prospectively collected data base was performed. Demographic and clinical data, angiographic features of the dural arteriovenous fistulas, procedural parameters, complications, treatment success, follow-up imaging, and clinical outcome were assessed. - RESULTS: Twenty-two patients were treated in 25 procedures. All patients were symptomatic, of whom 81.8% presented with tinnitus; 9.1%, with ocular symptoms; and 9.1%, with headache. Most fistulas were located at the transverse and/or sigmoid sinus. The most frequent fistula type was Cognard IIa+b (40.9%), followed by Cognard I (31.8%) and Cognard IIa (27.3%)/Borden I (59.1%), followed by Borden II (40.9%). The affected sinus could be preserved in all except for 1 patient in whom it was sacrificed in a second treatment procedure by coil embolization. The overall complete occlusion rate was 86.4%. The overall complication rate was 20%, with transient and permanent morbidity and mortality of 8%, 0%, and 0%, respectively. After a mean follow-up of 18 months, most patients (68.2%) achieved complete symptom remission, 27.3% showed symptom relief, and 4.6% had stable symptoms. - CONCLUSIONS: Transarterial liquid embolization of dural arteriovenous fistulas in combination with transvenous balloon-assisted protection of the venous sinus is feasible and safe and offers high rates of occlusion and of symptom remission.