Intracranial Dural Arteriovenous Fistulas: The Sinus and Non-Sinus Concept.
Acta Neurochir Suppl
; 132: 113-122, 2021.
Article
en En
| MEDLINE
| ID: mdl-33973038
ABSTRACT
INTRODUCTION:
Dural arteriovenous fistulas (dAVFs) account for 10-15% of all intracranial arteriovenous lesions. Different classification strategies have been proposed in the course of the years. None of them seems to guide the treatment strategy.OBJECTIVE:
We expose the experience of the vascular group at Niguarda Hospital and we propose a very practical classification method based on the location of the shunt. We divide dAVF in sinus and non-sinus in order to simplify our daily practice, as this classification method is simply based on the involvement of the sinuses. MATERIAL ANDMETHODS:
477 intracranial dural arteriovenous fistulas have been treated. 376 underwent endovascular treatment and 101 underwent surgical treatment. Cavernous sinus DAVFs and Galen ampulla malformations have been excluded from this series as they represent a different pathology per se. 376 dAVFs treated by endovascularapproach:
180 were sinus and 179 were non-sinus. 101 dAVFs treated with surgicalapproach:
15 were sinus and 86 were non-sinus.DISCUSSION:
Of the 477 intracranial dAVF the recorded mortality and severe disability was 3% and morbidity less than 4%. All patients underwent a postoperative DSA with nearly 100% of complete occlusion of the fistula. At a mean follow-up of 5 years in one case there was a non-sinus fistula recurrence, due to the presence of a partial clipping of "piè" of the vein.CONCLUSIONS:
The sinus and non-sinus concept has guided our institution for years and has led to good clinical results. This paper intends to share this practical classification with the neurosurgical community.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Seno Cavernoso
/
Malformaciones Vasculares del Sistema Nervioso Central
/
Embolización Terapéutica
Tipo de estudio:
Qualitative_research
Límite:
Humans
Idioma:
En
Revista:
Acta Neurochir Suppl
Año:
2021
Tipo del documento:
Article
País de afiliación:
Italia