Dural arteriovenous fistulas are not observed to convert to a higher grade after partial embolization

Authors

• Erin Walker, University of South Carolina School of Medicine, Greenville, South Carolina.
• Anja Srienc, Department of Neurological Surgery, Washington University in St. Louis, Missouri.
• Daphne Lew, Center for Biostatistics and Data Science, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
• Ridhima Guniganti, Department of Neurological Surgery, Washington University in St. Louis, Missouri.
• Giuseppe Lanzino, Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
• Waleed Brinjikji, Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
• Minako Hayakawa, Department of Radiology and Interventional Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
• Edgar A. Samaniego, Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
• Colin P. Derdeyn, Department of Radiology and Interventional Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
• Rose Du, Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts.
• Rosalind Lai, Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts.
• Jason P. Sheehan, Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
• Robert M. Starke, Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida.
• Adib Abla, Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida.
• Ahmed Abdelsalam, Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida.
• Bradley Gross, Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
• Felipe Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
• Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
• Louis J. Kim, Department of Neurosurgery, University of Washington, Seattle, Washington.
• Michael Levitt, Department of Neurosurgery, University of Washington, Seattle, Washington.
• Sepideh Amin-Hanjani, Neurosurgery Department, University Hospitals/Case Western Reserve University, Cleveland, Ohio.
• Ali Alaraj, Department of Neurosurgery, University of Illinois College of Medicine at Chicago, Illinois.
• Ethan Winkler, Department of Neurosurgery, University of California, San Francisco, California.
• W Christopher Fox, Department of Neurosurgery, University of Florida, Gainesville, Florida.
• Adam Polifka, Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida.
• Samuel Hall, Wessex Neurological Centre, Southampton General Hospital, Southampton, United Kingdom.
• Diederik Bulters, Wessex Neurological Centre, Southampton General Hospital, Southampton, United Kingdom.
• Andrew Durnford, Wessex Neurological Centre, Southampton General Hospital, Southampton, United Kingdom.
• Junichiro Satomi, Department of Neurosurgery, University of Tokushima, Japan.
• Yoshiteru Tada, Department of Neurosurgery, University of Tokushima, Japan.
• J Marc van Dijk, Department of Neurosurgery, University of Groningen, The Netherlands; and.

Document Type

Article

Abstract

OBJECTIVE: Borden-Shucart type I dural arteriovenous fistulas (dAVFs) lack cortical venous drainage and occasionally necessitate intervention depending on patient symptoms. Conversion is the rare transformation of a low-grade dAVF to a higher grade. Factors associated with increased risk of dAVF conversion to a higher grade are poorly understood. The authors hypothesized that partial treatment of type I dAVFs is an independent risk factor for conversion. METHODS: The multicenter Consortium for Dural Arteriovenous Fistula Outcomes Research database was used to perform a retrospective analysis of all patients with type I dAVFs. RESULTS: Three hundred fifty-eight (33.2%) of 1077 patients had type I dAVFs. Of those 358 patients, 206 received endovascular treatment and 131 were not treated. Two (2.2%) of 91 patients receiving partial endovascular treatment for a low-grade dAVF experienced conversion to a higher grade, 2 (1.5%) of 131 who were not treated experienced conversion, and none (0%) of 115 patients who received complete endovascular treatment experienced dAVF conversion. The majority of converted dAVFs localized to the transverse-sigmoid sinus and all received embolization as part of their treatment. CONCLUSIONS: Partial treatment of type I dAVFs does not appear to be significantly associated with conversion to a higher grade.

Medical Subject Headings

Humans; Retrospective Studies; Central Nervous System Vascular Malformations (diagnostic imaging, surgery); Embolization, Therapeutic (adverse effects); Endovascular Procedures (adverse effects); Risk Factors; Treatment Outcome

Publication Date

3-1-2024

Publication Title

Neurosurgical focus

E-ISSN

1092-0684

Volume

56

Issue

3

First Page

E8

PubMed ID

38428013

Digital Object Identifier (DOI)

10.3171/2024.1.FOCUS23745

Recommended Citation

Walker, Erin; Srienc, Anja; Lew, Daphne; Guniganti, Ridhima; Lanzino, Giuseppe; Brinjikji, Waleed; Hayakawa, Minako; Samaniego, Edgar A.; Derdeyn, Colin P.; Du, Rose; Lai, Rosalind; Sheehan, Jason P.; Starke, Robert M.; Abla, Adib; Abdelsalam, Ahmed; Gross, Bradley; Albuquerque, Felipe; Lawton, Michael T.; Kim, Louis J.; Levitt, Michael; Amin-Hanjani, Sepideh; Alaraj, Ali; Winkler, Ethan; Fox, W Christopher; Polifka, Adam; Hall, Samuel; Bulters, Diederik; Durnford, Andrew; Satomi, Junichiro; Tada, Yoshiteru; and van Dijk, J Marc, "Dural arteriovenous fistulas are not observed to convert to a higher grade after partial embolization" (2024). Neurosurgery. 1992.
https://scholar.barrowneuro.org/neurosurgery/1992