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Endovascular treatment of anterior cranial fossa dural arteriovenous fistula: a multicenter series

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

We report a multicenter experience using endovascular embolization as the first line approach for treatment of anterior cranial fossa (ACF) dural arteriovenous fistula (DAVF).

Methods

All patients with DAVFs located in the anterior cranial fossa who were treated with endovascular technique as a first line approach were included. Demographics, clinical presentation, angioarchitecture, strategy, complications, immediate angiographic, and follow-up results were included in the analysis.

Results

Twenty-three patients met the inclusion criteria (18 male and 5 female). Age ranged from 14 to 79 years (mean 53 years). Twelve patients presented with hemorrhage. Twenty-eight endovascular procedures were performed. The overall immediate angiographic cure rate after endovascular treatment was 82.6% (19/23 patients). The angiographic cure rate of the transvenous strategy was significantly superior to the transarterial strategy (p ≤ 0.001). There was 1 complication in 28 total procedures (3.6%). Angiographic follow-up was available in 21 out of the 23 patients with a mean of 25 months (range 2 to 108 months). In these 21 patients, the DAVF was completely cured in 20 (95%). At last follow-up, all patients had a modified Rankin scale (mRS) 0 to 2.

Conclusion

Our experience suggests that endovascular treatment for ACF DAVFs has an acceptable safety profile with high rates of complete occlusion, particularly with transvenous approach. Whenever possible, transvenous approach should be preferred over transarterial approach as first line strategy.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Division of Interventional Neuroradiology/NeuroEndovascular Surgery, Miami Neuroscience Institute – Baptist Hospital, Miami, FL, USA

    Guilherme Dabus, Italo Linfante & Michael W. McDermott

  2. Miami Cardiac & Vascular Institute, 8900 N. Kendall Drive, Miami, FL, 33176, USA

    Guilherme Dabus

  3. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA

    Peter Kan

  4. Interventional Neuroradiology at Incare, Universidad de Antioquia, Medellin, Colombia

    Carlos Diaz

  5. Interventional Neuroradiology at Angioteam, Medellin, Colombia

    Boris Pabon & Juan Andres-Mejia

  6. Department of Neurosurgery, Emory University, Atlanta, GA, USA

    Jonathan A. Grossberg & Brian M. Howard

  7. Department of Neuroradiology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey

    Civan Islak, Naci Kocer & Osman Kizilkilic

  8. Department of Radiology, University of Massachusetts, Worcester, MA, USA

    Ajit S. Puri, Anna L. Kuhn & Viraj Moholkar

  9. Department of Neurology and Radiology, University of Iowa, Iowa City, IA, USA

    Santiago Ortega-Gutierrez & Edgar A. Samaniego

Authors
  1. Guilherme Dabus
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  2. Peter Kan
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  3. Carlos Diaz
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  4. Boris Pabon
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  5. Juan Andres-Mejia
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  6. Italo Linfante
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  7. Jonathan A. Grossberg
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  8. Brian M. Howard
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  9. Civan Islak
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  10. Naci Kocer
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  11. Osman Kizilkilic
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  12. Ajit S. Puri
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  13. Anna L. Kuhn
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  14. Viraj Moholkar
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  15. Santiago Ortega-Gutierrez
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  16. Edgar A. Samaniego
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  17. Michael W. McDermott
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Corresponding author

Correspondence to Guilherme Dabus.

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Conflict of interest

Guilherme Dabus, MD: Consultant Medtronic, Microvention, Penumbra, Cerenovus.

Peter Kan. MD: Consultant: Stryker, Microvention, Cerenovus.

Carlos Diaz, MD: Consultant: Medtronic.

Boris Pabon, MD: Consultant: Medtronic, Microvention, Stryker, MIVI, Syntheon.

Juan Andres-Mejia, MD: None.

Italo Linfante, MD: Consultant: Medtronic, Stryker, Prolong Pharmaceuticals.

Jonathan A. Grossberg, MD: Georgia Research Alliance Grant; Consultant: Cognition Medical.

Brian M. Howard, MD: None.

Civan Islak, MD: Consultant: Microvention.

Naci Kocer, MD: Consultant: Microvention.

Osman Kizilkilic, MD: None.

Viraj Moholkar, MD: None.

Anna L. Kuhn, MD: None.

Ajit S. Puri, MD: Consultant: Stryker, Medtronic, Cerenovus, Microvention, CereVasc, Merit; Received research grants from Stryker, Medtronic, Cerenovus, Microvention.

Santiago Ortega-Gutierrez, MD: Consultant for Stryker.

Edgar A. Samaniego, MD: Consultant for Microvention, Medtronic.

Michael W. McDermott, MD: None.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. The data included in the manuscript has been all de-identified.

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Dabus, G., Kan, P., Diaz, C. et al. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula: a multicenter series. Neuroradiology 63, 259–266 (2021). https://doi.org/10.1007/s00234-020-02536-3

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  • DOI: https://doi.org/10.1007/s00234-020-02536-3

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