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Intracranial and Spinal Dural Arteriovenous Fistulas pp 285–301Cite as

Hemorrhagic Complications After Endovascular Treatment for Intracranial Dural Arteriovenous Fistulas

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Abstract

Dural arteriovenous fistulas (DAVFs) are arteriovenous shunts within the dural leaflet. Endovascular treatment (EVT) has become the first-line treatment for DAVFs. However, during or after EVT, disastrous hemorrhagic complications can occur. Little is known about the potential for severe hemorrhagic complications. Currently, EVT-associated hemorrhage may be considered associated with the rupture of a glomus-like structure around the draining vein, which is often supplied by a pial artery. In addition, excessive Onyx occluding the ostium of cortical veins may result in venous hypertension, which carries a risk of venous hemorrhage. Therefore, the major pial arterial supply should be occluded first, and patency of the involved sinus and its tributaries should be preserved. To decrease EVT-associated hemorrhagic complications, staged EVT may be helpful after occlusion of the risky draining vein. EVT-associated hemorrhagic complications are often disastrous due to the nature of venous hypertension. If the hemorrhage can be evacuated after urgent craniotomy, especially in cases of supratentorial or epidural hemorrhage, a good outcome can be achieved.

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Acknowledgments

We thank our colleagues who provided the case images.

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The authors declare that they have no conflicts of interest.

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Ethics approval is not needed for review articles at our institution.

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Informed consent was obtained from all individual participants included in the study or their legal guardians.

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  1. Department of Neurosurgery, First Hospital of Jilin University, Changchun, China

    Kun Hou & Jinlu Yu

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  1. Kun Hou
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Correspondence to Jinlu Yu .

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Editors and Affiliations

  1. Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

    Xianli Lv

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Hou, K., Yu, J. (2022). Hemorrhagic Complications After Endovascular Treatment for Intracranial Dural Arteriovenous Fistulas. In: Lv, X. (eds) Intracranial and Spinal Dural Arteriovenous Fistulas. Springer, Singapore. https://doi.org/10.1007/978-981-19-5767-3_20

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  • DOI: https://doi.org/10.1007/978-981-19-5767-3_20

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