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Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients

Abstract

This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS{sub d}AVF). A total of 150 consecutive patients and 348 procedures were evaluated. Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS{sub d}AVFs. More than half of the affected sinuses were partially or completely thrombosed. Access-wise treatment was performed transarterial (n = 33), transvenous (n = 21), or a combination thereof (n = 96). A mean of 2.4 procedures per patient was required. Immediate postprocedural occlusion rate after transarterial embolization was 30% only. Transvenous treatment alone resulted in an early occlusion rate of 81%, with delayed complete obliteration of half of the remaining fistulas. After combined transarterial/transvenous treatment, the angiographic cure rate was 54%. At follow-up, 88% of patients with residual shunt after the treatment showed complete occlusion. The cumulative complication rate was 9% (n = 13), with minor adverse events in ten patients (7%) and major complications in three patients (2%). Transvenous coil occlusion of the sinus segment with the adjacent dAVF site, eventually combined with transarterial occlusion of supplying arteries, is a very effective and well-tolerated treatment method. In selected patients,  More>>
Authors:
Kirsch, M; [1]  Liebig, T; [2]  Kuehne, D; [3]  Henkes, H [4] 
  1. Ernst-Moritz-Arndt-Universitaet Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany)
  2. TU Muenchen, Institut fuer Neuroradiologie, Klinikum Rechts der Isar, Munich (Germany)
  3. Klinik fuer Radiologie und Neuroradiologie, Alfried-Krupp-Krankenhaus, Essen (Germany)
  4. Katharinenhospital-Klinikum Stuttgart, Klinik fuer Neuroradiologie, Stuttgart (Germany)
Publication Date:
Jul 15, 2009
Product Type:
Journal Article
Resource Relation:
Journal Name: Neuroradiology; Journal Volume: 51; Journal Issue: 7
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; FISTULAE; HEMORRHAGE; VASCULAR DISEASES
OSTI ID:
21223296
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0028-3940; NRDYAB; TRN: DE09FA951
Availability:
Available from: http://dx.doi.org/10.1007/s00234-009-0524-9
Submitting Site:
DEN
Size:
page(s) 477-483
Announcement Date:
Oct 13, 2009

Citation Formats

Kirsch, M, Liebig, T, Kuehne, D, and Henkes, H. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients. Germany: N. p., 2009. Web. doi:10.1007/S00234-009-0524-9.
Kirsch, M, Liebig, T, Kuehne, D, & Henkes, H. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients. Germany. doi:10.1007/S00234-009-0524-9.
Kirsch, M, Liebig, T, Kuehne, D, and Henkes, H. 2009. "Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients." Germany. doi:10.1007/S00234-009-0524-9. https://www.osti.gov/servlets/purl/10.1007/S00234-009-0524-9.
@misc{etde_21223296,
title = {Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients}
author = {Kirsch, M, Liebig, T, Kuehne, D, and Henkes, H}
abstractNote = {This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS{sub d}AVF). A total of 150 consecutive patients and 348 procedures were evaluated. Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS{sub d}AVFs. More than half of the affected sinuses were partially or completely thrombosed. Access-wise treatment was performed transarterial (n = 33), transvenous (n = 21), or a combination thereof (n = 96). A mean of 2.4 procedures per patient was required. Immediate postprocedural occlusion rate after transarterial embolization was 30% only. Transvenous treatment alone resulted in an early occlusion rate of 81%, with delayed complete obliteration of half of the remaining fistulas. After combined transarterial/transvenous treatment, the angiographic cure rate was 54%. At follow-up, 88% of patients with residual shunt after the treatment showed complete occlusion. The cumulative complication rate was 9% (n = 13), with minor adverse events in ten patients (7%) and major complications in three patients (2%). Transvenous coil occlusion of the sinus segment with the adjacent dAVF site, eventually combined with transarterial occlusion of supplying arteries, is a very effective and well-tolerated treatment method. In selected patients, variations of these methods (e.g., sinus stenting, compartmental sinus occlusion) can be useful. (orig.)}
doi = {10.1007/S00234-009-0524-9}
journal = {Neuroradiology}
issue = {7}
volume = {51}
place = {Germany}
year = {2009}
month = {Jul}
}