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The VEBAS score: a practical scoring system for intracranial dural arteriovenous fistula obliteration.
Becerril-Gaitan, Andrea; Ding, Dale; Ironside, Natasha; Buell, Thomas J; Kansagra, Akash P; Lanzino, Giuseppe; Brinjikji, Waleed; Kim, Louis; Levitt, Michael R; Abecassis, Isaac Josh; Bulters, Diederik; Durnford, Andrew; Fox, W Christopher; Blackburn, Spiros; Chen, Peng Roc; Polifka, Adam J; Laurent, Dimitri; Gross, Bradley; Hayakawa, Minako; Derdeyn, Colin; Amin-Hanjani, Sepideh; Alaraj, Ali; van Dijk, J Marc C; Potgieser, Adriaan R E; Starke, Robert M; Peterson, Eric C; Satomi, Junichiro; Tada, Yoshiteru; Abla, Adib A; Winkler, Ethan A; Du, Rose; Lai, Pui Man Rosalind; Zipfel, Gregory J; Chen, Ching-Jen; Sheehan, Jason P.
Afiliación
  • Becerril-Gaitan A; Neurosurgery Department, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Ding D; Neurosurgery Department, University of Louisville, Louisville, Kentucky, USA.
  • Ironside N; Neurosurgery Department, University of Virginia Health System, Charlottesville, Virginia, USA.
  • Buell TJ; Neurosurgery Department, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Kansagra AP; Neurosurgery Department, Washington University School of Medicine, St. Louis, Missouri, USA.
  • Lanzino G; Neurosurgery Department, Mayo Clinic, Rochester, Minnesota, USA.
  • Brinjikji W; Neurosurgery Department, Mayo Clinic, Rochester, Minnesota, USA.
  • Kim L; Neurosurgery Department, University of Washington, Seattle, Washington, USA.
  • Levitt MR; Neurosurgery Department, University of Washington, Seattle, Washington, USA.
  • Abecassis IJ; Neurosurgery Department, University of Louisville, Louisville, Kentucky, USA.
  • Bulters D; Neurosurgery Department, University of Southampton, Southampton, UK.
  • Durnford A; Neurosurgery Department, University of Southampton, Southampton, UK.
  • Fox WC; Neurosurgery Department, Mayo Clinic Jacksonville Campus, Jacksonville, Florida, USA.
  • Blackburn S; Neurosurgery Department, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Chen PR; Neurosurgery Department, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Polifka AJ; Neurosurgery Department, University of Florida, Gainesville, Florida, USA.
  • Laurent D; Neurosurgery Department, University of Florida, Gainesville, Florida, USA.
  • Gross B; Neurosurgery Department, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Hayakawa M; Radiology and Interventional Radiology Department, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
  • Derdeyn C; Radiology and Interventional Radiology Department, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
  • Amin-Hanjani S; Neurosurgery Department, University Hospitals/Case Western Reserve University, Cleveland, Ohio, USA.
  • Alaraj A; Neurosurgery Department, University of Illinois Chicago, Chicago, Illinois, USA.
  • van Dijk JMC; Neurosurgery Department, University of Groningen, Groningen, The Netherlands.
  • Potgieser ARE; Neurosurgery Department, University of Groningen, Groningen, The Netherlands.
  • Starke RM; Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Peterson EC; Radiology Department, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Satomi J; Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Tada Y; Neurosurgery Department, University of Tokushima, Tokushima, Japan.
  • Abla AA; Neurosurgery Department, University of Tokushima, Tokushima, Japan.
  • Winkler EA; Neurosurgery Department, University of California San Francisco, San Francisco, California, USA.
  • Du R; Neurosurgery Department, University of California San Francisco, San Francisco, California, USA.
  • Lai PMR; Neurosurgery Department, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Zipfel GJ; Neurosurgery Department, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Chen CJ; Neurosurgery Department, Washington University School of Medicine, St. Louis, Missouri, USA.
  • Sheehan JP; Neurosurgery Department, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
J Neurointerv Surg ; 16(3): 272-279, 2024 Feb 12.
Article en En | MEDLINE | ID: mdl-37130751
ABSTRACT

BACKGROUND:

Tools predicting intracranial dural arteriovenous fistulas (dAVFs) treatment outcomes remain scarce. This study aimed to use a multicenter database comprising more than 1000 dAVFs to develop a practical scoring system that predicts treatment outcomes.

METHODS:

Patients with angiographically confirmed dAVFs who underwent treatment within the Consortium for Dural Arteriovenous Fistula Outcomes Research-participating institutions were retrospectively reviewed. A subset comprising 80% of patients was randomly selected as training dataset, and the remaining 20% was used for validation. Univariable predictors of complete dAVF obliteration were entered into a stepwise multivariable regression model. The components of the proposed score (VEBAS) were weighted based on their ORs. Model performance was assessed using receiver operating curves (ROC) and areas under the ROC.

RESULTS:

A total of 880 dAVF patients were included. Venous stenosis (presence vs absence), elderly age (<75 vs ≥75 years), Borden classification (I vs II-III), arterial feeders (single vs multiple), and past cranial surgery (presence vs absence) were independent predictors of obliteration and used to derive the VEBAS score. A significant increase in the likelihood of complete obliteration (OR=1.37 (1.27-1.48)) with each additional point in the overall patient score (range 0-12) was demonstrated. Within the validation dataset, the predicted probability of complete dAVF obliteration increased from 0% with a 0-3 score to 72-89% for patients scoring ≥8.

CONCLUSION:

The VEBAS score is a practical grading system that can guide patient counseling when considering dAVF intervention by predicting the likelihood of treatment success, with higher scores portending a greater likelihood of complete obliteration.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Radiocirugia / Malformaciones Vasculares del Sistema Nervioso Central / Embolización Terapéutica Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Aged / Humans Idioma: En Revista: J Neurointerv Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Radiocirugia / Malformaciones Vasculares del Sistema Nervioso Central / Embolización Terapéutica Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Aged / Humans Idioma: En Revista: J Neurointerv Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos