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Updates in the management of cranial dural arteriovenous fistula.

ABSTRACT: Dural arteriovenous fistula (dAVF) accounts for approximately 10% of all intracranial vascular malformations. While they can be benign lesions, the presence of retrograde venous drainage and cortical venous reflux makes the natural course of these lesions aggressive high risk of haemorrhage, neurological injury and mortality. Endovascular treatment is often the first line of treatment for dAVF. Both transarterial and transvenous approaches are used to cure dAVF. The selection of treatment approach depends on the angioarchitecture of the dAVF, the location, the direction of venous flow. Surgery and, to a lesser extent, stereotactic radiosurgery are used when endovascular approaches are impossible or unsuccessful.

SUBMITTER: Baharvahdat H

PROVIDER: S-EPMC7213517 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Updates in the management of cranial dural arteriovenous fistula.

Baharvahdat Humain H Ooi Yinn Cher YC Kim Wi Jin WJ Mowla Ashkan A Coon Alexander L AL Colby Geoffrey P GP

Stroke and vascular neurology 20191121 1

Dural arteriovenous fistula (dAVF) accounts for approximately 10% of all intracranial vascular malformations. While they can be benign lesions, the presence of retrograde venous drainage and cortical venous reflux makes the natural course of these lesions aggressive high risk of haemorrhage, neurological injury and mortality. Endovascular treatment is often the first line of treatment for dAVF. Both transarterial and transvenous approaches are used to cure dAVF. The selection of treatment approa ...[more]

PMID: 32411408

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Potential biomarkers of spinal dural arteriovenous fistula: C4BPA and C1QA.

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| S-EPMC9215050 | biostudies-literature

Angioarchitecture of Spinal Dural Arteriovenous Fistula - Evaluation with 3D Rotational Angiography.

Project description:PURPOSE:The complex angioarchitecture of spinal dural arteriovenous fistulas (SDAVFs) sometimes preclude angiographic analyses or superselective procedures. Therefore, the effectiveness of 3 dimensional rotational angiography (3DRA) as a detailed imaging technique for SDAVFs was evaluated. MATERIALS AND METHODS:Of 57 patients with spinal vascular malformations, recent 13 SDAVF patients underwent 3DRA. The advantage of 3DRA compared to digital subtraction angiography (DSA) in imaging SDAVF was assessed. Angioarchitecture of SDAVF was focused on location, number, and course of feeders and draining vein. Appropriate angled views were also selected to reveal the segmental artery and feeders. RESULTS:3DRA technique provided additional information for imaging evaluation of SDAVFs compared to DSA; the presence of multiple feeders, including their transdural portions, as well as their courses. The contralaterally angled anterior-oblique-caudal (spider) view showed the radicular feeder by separating the intercostal artery and the dorsal muscular branch. The bottom-to-up (tunnel) view was useful for revealing the location (ventral vs. dorsal) including sharp medial turn of the dural feeder. The dual mode, which displays both vessels and bones, revealed the course of the feeders and the fistula related to the spinal bony column. CONCLUSION:Because spinal vasculature overlaps in DSA, 3DRA revealed additional information for evaluations of the number and transdural course of fistular feeders in SDAVFs, and it offers working angles to obtain appropriate views.

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Successful endovascular treatment of ruptured bilateral ophthalmic frontal dural arteriovenous fistula.

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Palatal Tremor with Progressive Ataxia Secondary to A Dural Arteriovenous Fistula.

Project description: Not available

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Endovascular Treatment of Medial Tentorial Dural Arteriovenous Fistula Through the Dural Branch of the Pial Artery.

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Middle cranial fossa sphenoidal region dural arteriovenous fistulas: anatomic and treatment considerations.

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| S-EPMC7965092 | biostudies-literature

Secondary ocular hypertension due to tentorial dural arteriovenous fistula: a case report.

Project description:BackgroundTentorial dural arteriovenous fistulas (TDAVFs) are abnormal shunts between meningeal arteries and the intradural venous system located in the tentorial dura mater, which typically manifest with haemorrhage or progressive neurological disorders. TDAVFs with pure ocular presentation have been rarely reported.Case presentationsThe case of a 56-year-old man presented with unilateral eye redness, proptosis and elevated intraocular pressure was reported herein, which was caused by a TDAVF. The fistula was fed by the left posterior cerebral artery and posterior meningeal artery. The drainage was into the basal vein and internal cerebral veins, which led the arterial blood flow forward to the left superior ophthalmic vein directly. The redundant blood flow caused the rise of episcleral venous pressure, leading to the clinical presentations. Gamma knife radiosurgery was performed then considering the delicate vascular structure and its deep location. The corkscrew hyperaemia was gradually alleviated after the surgery, but the intraocular pressure remained elevated at follow-ups.ConclusionDural arteriovenous fistulas which are not directly connected to cavernous sinus could cause ocular presentations like proptosis, eye redness and ocular hypertension.

| S-EPMC10496288 | biostudies-literature

Indocyanine Green Videoangiography in Negative: Spinal Dural Arteriovenous Fistula.

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Frequency and characteristics associated with inherited thrombophilia in patients with intracranial dural arteriovenous fistula.

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Updates in arteriovenous malformation management: the post-ARUBA era.

Project description:Brain arteriovenous malformations (AVMs) are complex and heterogeneous lesions that can rupture, causing significant morbidity and mortality. While ruptured lesions are usually treated, the management of unruptured AVMs remains unclear. A Randomized trial of Unruptured Brain Arteriovenous Malformations (ARUBA) was the first trial conducted to compare the effects of medical and interventional therapy. Although it concluded that medical therapy was superior in preventing stroke and death over a follow-up period of 33 months, the findings were met with intense criticism regarding several aspects of study design, progression, and analysis/conclusion. Namely, the increased use of stand-alone embolisation relative to microsurgery in a cohort with predominantly low-grade lesions combined with a short follow-up period amplified treatment risk. Subsequently, several observational studies were conducted on ARUBA-eligible patients to investigate the safety and efficacy of microsurgery, radiosurgery, and endovascular embolisation over longer follow-up periods. These reports showed that favourable safety profiles and cure rates can be achieved with appropriate patient selection and judicious use of different treatment modalities in multidisciplinary centres. Since large prospective randomised trials on AVMs may not be feasible, it is important to make use of practice-based data beyond the flawed ARUBA study to optimise patients' lifetime outcomes.

| S-EPMC7213498 | biostudies-literature

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