Endovascular embolization is an effective treatment option for cerebral arteriovenous malformation (AVM) and dural arteriovenous fistulas (DAVFs). The objective of this study was to assess the safety and efficacy of Menox in patients with cranial dural arteriovenous fistulas. : From January 2021 to January 2023, 19 patients with intracranial DAVFs underwent embolization procedures. All patients were treated by embolization with Menox or/and in combination with other embolization products such as Onyx (Covidien, Irvine, California), PHIL (MicroVention, Tustin, California), and Squid (Balt Extrusion, Montmorency, France). Treatment approaches were selected depending on the anatomical location of the fistula. Patients were monitored and followed-up for 12 months. : The patients' mean age was 56.26 ± 16.49 years. Of these 19 patients, 58% ( = 11) were treated with the Menox liquid embolizing agent (LEA) alone or in combination with different LEAs, while = 7 were treated with other LEAs and 1 patient was treated solely with coils. Complete occlusion of DAVFs with Menox and other agents was evident in 68.4% ( = 13/19) of patients. Complete occlusion (100%) was observed in the sinus rectus, transverse sinus, and diploic veins of the orbital roof, while complete occlusion was observed in 50% of falcotentorial patients and 60% of superior sagittal sinus patients. The lowest rate of complete fistula obliteration was observed in the dural carotid cavernous fistula (CCF) group (25%). An intra-procedural adverse event occurred in one patient. No other post-procedural adverse events were noted. Furthermore, in patients treated with Menox, total occlusion was achieved in 72.7% ( = 8) of patients, whereas the non-Menox group had 62.5% ( = 5) of patients with 100% occlusion and 37.5% ( = 3) of patients with subtotal occlusion. : Outcomes using Menox alone and in combination with other agents were effective, and it is safe for the treatment of dural arteriovenous fistulas.
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http://dx.doi.org/10.3390/jcm13195899 | DOI Listing |
Neurol India
November 2024
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Infantile dural arteriovenous fistula (IDAVF) is a rare complex dural arteriovenous fistulas. This study is to provide a comprehensive understanding of the angioarchitecture of arteriovenous shunts in IDAVFs and planning endovascular treatment. Five cases of IDAVF and a literature review were analyzed to characterize the shunt patterns of IDAVFs in terms of anatomic relations to the arterial feeder, sinuses, and cortical veins.
View Article and Find Full Text PDFCureus
November 2024
Department of Surgery, Baghdad Teaching Hospital, Medical City Complex, Baghdad, IRQ.
The petrous and tentorial dural arteriovenous fistulas are vascular malformations that are very infrequent but highly aggressive, with a significant risk of intracranial hemorrhage and neurological deficits. Optimal management remains one of the most debated subjects, with various series reporting endovascular and microsurgical approaches. Therefore, this systematic review aims to assess the efficacy, safety, and outcomes of different treatment modalities of petrous and tentorial dural arteriovenous fistulas (DAVFs) based on clinical presentation, imaging techniques, treatment outcome, and complications arising in the course of their treatment.
View Article and Find Full Text PDFStroke
December 2024
Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.(H.J.).
Acta Neurochir (Wien)
December 2024
Department of Neurosurgery, National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Zhong Road, Shanghai, 200040, China.
Background: Craniocervical junction (CCJ) dural arteriovenous fistulas (DAVFs) represent a rare yet critical vascular anomaly that may result in significant neurological impairments.
Method: We report the case of a 52-year-old male with a history of medullary hemorrhage who underwent surgical intervention for a left CCJ DAVF. Through comprehensive surgical planning and meticulous intraoperative monitoring, multiple feeders of the DAVF were safely coagulated and transected, with successful DAVF obliteration confirmed by intraoperative angiography.
AJNR Am J Neuroradiol
December 2024
Department of Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
Background And Purpose: Lateral sinus dural arteriovenous fistulas (LS-DAVFs) carry a higher rate of recurrence after endovascular treatment (EVT). Our objective was to investigate the independent predictors of recurrence and unfavorable functional outcome of low-and intermediate-grade LS-DAVFs after EVT.
Materials And Methods: Retrospectively reviewed our database of prospectively collected information for all patients with low and intermediate-grade LS-DAVFs that underwent EVT from May 2004 to December 2021.
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