AI Article Synopsis

  • - The study reviews rare cases of new dural arteriovenous fistulas (DAVFs) that developed after the treatment of cavernous sinus DAVFs (CSDAVFs), analyzing both institutional cases and related literature from June 2004 to September 2019.
  • - Out of 119 treated CSDAVFs in the institution, 3 cases (2.5%) of de novo DAVFs were identified; the literature search revealed 12 additional cases from 9 articles, primarily affecting women with a mean age of 55 years.
  • - The findings suggest that factors like sinus thrombosis and elevated venous pressure might contribute to the formation of new DAVFs, with additional influences from thrombophilia and contraceptive use

Article Abstract

Background: The development of new dural arteriovenous fistulas (DAVFs) at another location following endovascular treatment of cavernous sinus DAVFs (CSDAVFs) are extremely rare. Our aim is to review cases of de Novo DAVFs that occurred after treatment of CSDAVFs at our institution and those reported in the literature.

Methods: We reviewed all cases of CSDAVFs evaluated by 2 experienced neuroradiologists. A literature search was performed using the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines focusing on De Novo DAVFs following the endovascular treatment of cerebrovascular malformations. Addition articles were searched through the reference lists of the included articles.

Results: From June 2004 and September 2019., we identified 3 (2.5%) cases of De Novo DAVFs occurred after endovascular treatment or spontaneous obliteration of CSDAVFs from 119 treated CSDAVFs at our institute. Our review yielded 9 articles involving 12 patients with 15 de novo DAVFs, including our 3 patients. The mean age was 55.08 ± 12.9 years (range 43-69), 83.3% were females ( = 10). The new remote DAVFs occurred after endovascular treatment of CSDAVFs in 10 (83.3%) patients. The de novo DAVFs occurred following spontaneous complete regression in 2 (16.7%) patients. All de novo DAVFs developed after complete obliteration of treated CSDAVFs.

Conclusion: Sinus thrombosis and elevated venous pressure may play an important role in the pathogenesis of a de novo DAVF formation. In addition, thrombophilic abnormalities and the use of contraceptives may contribute to sinus thrombosis, leading to the development of the second remote DAVF after treatment of CSDAVFs.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943475PMC
http://dx.doi.org/10.1016/j.wnsx.2024.100307DOI Listing

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Article Synopsis
  • - The study reviews rare cases of new dural arteriovenous fistulas (DAVFs) that developed after the treatment of cavernous sinus DAVFs (CSDAVFs), analyzing both institutional cases and related literature from June 2004 to September 2019.
  • - Out of 119 treated CSDAVFs in the institution, 3 cases (2.5%) of de novo DAVFs were identified; the literature search revealed 12 additional cases from 9 articles, primarily affecting women with a mean age of 55 years.
  • - The findings suggest that factors like sinus thrombosis and elevated venous pressure might contribute to the formation of new DAVFs, with additional influences from thrombophilia and contraceptive use
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Intracranial dural arteriovenous fistulas (dAVF) account for nearly 10-15% of all arteriovenous malformations. Although the majority of dAVF are effectively cured after endovascular intervention, there are cases of dAVFs that may recur after radiographic cure. We present the case of a 69-year-old female with de novo formation of three dAVFs in different anatomic locations after successive endovascular treatments.

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A 71-year-old man, with a pial micro-arteriovenous malformation (pAVM) draining into the confluence of the vein of Trolard and the vein of Labbé was surgically removed, sparing these cortical veins. 4-months MR and angiographic controls showed a de novo dural arteriovenous fistula (dAVF) draining into the previously spared cortical veins. It was removed using intraoperative motor evoked potentials (MEP).

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