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Radiosurgery for dural arteriovenous fistulas
Christopher J Koebbe1, Dhruv Singhal, Jason Sheehan
1Department of Neurological Surgery, Center for Image-Guided Neurosurgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Surgical Neurology
|October 29, 2005
Summary
Stereotactic radiosurgery effectively treats dural arteriovenous fistulas (DAVFs), offering long-term symptom relief. This study shows high rates of symptom resolution and DAVF obliteration with radiosurgery, with or without embolization.
Area of Science:
- Neurosurgery
- Radiology
- Vascular Surgery
Background:
- Dural arteriovenous fistulas (DAVFs) are a subset of arteriovenous malformations.
- Stereotactic radiosurgery has shown promise for treating DAVFs.
Purpose of the Study:
- To evaluate the efficacy and outcomes of stereotactic radiosurgery for dural arteriovenous fistulas.
- To analyze the role of embolization in conjunction with radiosurgery for DAVFs.
Main Methods:
- Retrospective analysis of 18 patients with 23 DAVFs treated between 1991 and 2002.
- Patients received gamma knife radiosurgery alone (n=8) or with embolization (n=10).
- Data collected included DAVF location, drainage, dosimetry, clinical outcomes, and imaging results.
Main Results:
- Complete symptom resolution in 9 patients; partial resolution in 9 patients.
- Angiographic follow-up demonstrated complete DAVF obliteration in all evaluated cases.
- No intracranial hemorrhage occurred; temporary hemiparesis in 1 patient, permanent deficits in 2 post-embolization.
Conclusions:
- Stereotactic radiosurgery is an effective treatment for selected patients with dural arteriovenous fistulas.
- It offers durable symptom relief and angiographic obliteration of DAVFs.