RT Journal Article
SR Electronic
T1 Low- and Intermediate-Grade Lateral Sinus Dural Arteriovenous Fistulas: Factors Affecting the Outcome of Endovascular Treatment over 18-Year Experience in a High-Volume Neurovascular Center
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1152
OP 1158
DO 10.3174/ajnr.A8622
VO 46
IS 6
A1 Duan, Guoli
A1 Zhang, Yuhang
A1 Wang, Yang
A1 Li, Zhe
A1 Shang, Chenghao
A1 Chen, Rundong
A1 Zhao, Rui
A1 Yang, Pengfei
A1 Dai, Dongwei
A1 Fang, Yibin
A1 Huang, Qinghai
A1 Hong, Bo
A1 Xu, Yi
A1 Li, Qiang
A1 Liu, Jianmin
YR 2025
UL http://www.ajnr.org/content/46/6/1152.abstract
AB 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 outcomes of low-and intermediate-grade LS-DAVFs after EVT.MATERIALS AND METHODS: We retrospectively reviewed our database of prospectively collected information for all patients with low- and intermediate-grade LS-DAVFs who underwent EVT from May 2004 to December 2021. Patient demographics, angiographics, treatment, and outcomes were analyzed to identify independent predictors of recurrence and unfavorable outcomes.RESULTS: One hundred and seventeen patients with 117 low- and intermediate-grade LS-DAVFs who underwent EVT were included in this study. The mean age of the patients was 53.0 ± 17.5 years. Immediately complete obliteration was achieved in 103/117 (88%) patients after EVT. Clinical follow-up was available for all 117 patients, with an unfavorable outcome rate of 5.1%. Angiographic follow-up was available in 91 patients (78%). Recurrence occurred in 16 (18%) patients and 8 (6.8%) received retreatment. Contralateral sinus severe stenosis or occlusion was an independent high-risk factor for the unfavorable outcome (OR = 11.7; 95% CI: 1.9–70.9, P < .01) and recurrence (OR = 63.8; 95% CI: 10.3–396.5, P < .01) for low- and intermediate-grade LS-DAVFs at follow-up.CONCLUSIONS: Contralateral sinus severe stenosis or occlusion represents a stronger independent risk factor associated with recurrence and unfavorable outcomes in patients with low- and intermediate-grade LS-DAVFs when the involved ipsilateral sinus was occluded after EVT. For patients with LS-DAVFs, the patency of the contralateral sinus should be considered when making therapeutic decisions.AUCarea under the ROC curveCNcranial nerveCVDcortical venous drainageEVTendovascular treatmentIQRinterquartile rangeLS-DAVFlateral sinus dural arteriovenous fistulaROCreceiver operating characteristic