Endovascular Treatment of Tentorial Dural Arteriovenous Fistulae

Tentorial dural arteriovenous fistula (DAVF) is a rare vascular disease, which accounts for less than 4% of all cases of intracranial DAVF. Because of the high risk of intracranial hemorrhage, patients with tentorial DAVF need aggressive treatment. Management approaches are still controversial, and...

Full description

Saved in:
Bibliographic Details
Published in:Interventional neuroradiology 2012-03, Vol.18 (1), p.60-68
Main Authors: Wajnberg, E., Spilberg, G., Rezende, M.T., Abud, D.G., Kessler, I., Mounayer, C.
Format: Article
Language:English
Subjects:
Adult
Aged
Arteriovenous Fistula - complications
Arteriovenous Fistula - diagnostic imaging
Arteriovenous Fistula - therapy
Cerebral Angiography
Dura Mater - blood supply
Embolization, Therapeutic
Female
Humans
Intracranial Hemorrhages - diagnostic imaging
Intracranial Hemorrhages - etiology
Intracranial Hemorrhages - therapy
Male
Middle Aged
Original
Retrospective Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Tentorial dural arteriovenous fistula (DAVF) is a rare vascular disease, which accounts for less than 4% of all cases of intracranial DAVF. Because of the high risk of intracranial hemorrhage, patients with tentorial DAVF need aggressive treatment. Management approaches are still controversial, and endovascular treatment has emerged as an effective alternative. In the current work, we describe our experience with the endovascular approach in the treatment of these deep and complex DAVF of the tentorium. Eight patients were treated between January 2006 and July 2009. Six patients (75%) presented with intracranial hemorrhage related to the DAVF rupture. Four patients (50%) had subarachnoid bleeding and two had intraparenchymal hematoma. Endovascular treatment was performed via the transarterial route alone in five cases (62.5%), by the transvenous approach in two cases (25.0%) and in a combined procedure using both arterial and venous routes in one patient (12.5%). Complete obliteration of the fistula was achieved in all cases. The outcome at 15 months was favorable (modified Rankin scale 0–3) in seven (87.5%) patients. Complete cure of the lesion was confirmed in these cases. This paper reports on the effectiveness of endovascular treatment in tentorial DAVF management. The choice of the venous versus the arterial approach is determined by regarding different anatomical dispositions.
ISSN:1591-0199
2385-2011
DOI:10.1177/159101991201800108