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

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 embolizati...

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Hauptverfasser: Vollherbst, Dominik (VerfasserIn) , Ulfert, Christian (VerfasserIn) , Neuberger, Ulf (VerfasserIn) , Herweh, Christian (VerfasserIn) , Laible, Mona (VerfasserIn) , Nagel, Simon (VerfasserIn) , Bendszus, Martin (VerfasserIn) , Möhlenbruch, Markus Alfred (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2018
In: American journal of neuroradiology
Year: 2018, Jahrgang: 39, Heft: 7, Pages: 1296-1302
ISSN:1936-959X
DOI:10.3174/ajnr.A5651
Online-Zugang:Verlag, Volltext: https://doi.org/10.3174/ajnr.A5651
Verlag, Volltext: http://www.ajnr.org/content/39/7/1296
Volltext
Verfasserangaben:D.F. Vollherbst, C. Ulfert, U. Neuberger, C. Herweh, M. Laible, S. Nagel, M. Bendszus, and M.A. Möhlenbruch
Beschreibung
Zusammenfassung: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.
Beschreibung:Gesehen am 28.03.2019
Beschreibung:Online Resource
ISSN:1936-959X
DOI:10.3174/ajnr.A5651

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