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A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail
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Radiosurgery for Dural Arteriovenous Fistulas
Huai-Che Yang1, Cheng-Chia Lee2, David H C Pan2
1Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, wade012@gmail.com.
Progress in Neurological Surgery
|May 17, 2019
Summary
Stereotactic radiosurgery (SRS) offers a safe, effective treatment for select intracranial dural arteriovenous fistulas (DAVFs). While slower than other methods, SRS provides a minimally invasive option, avoiding complications associated with aggressive DAVF treatments.
Area of Science:
- Neurosurgery
- Radiology
Background:
- Intracranial dural arteriovenous fistulas (DAVFs) involve abnormal connections in the dura mater.
- These fistulas shunt blood from meningeal arteries directly into dural sinuses or leptomeningeal veins.
Purpose of the Study:
- To evaluate stereotactic radiosurgery (SRS) as a treatment for intracranial dural arteriovenous fistulas (DAVFs).
- To compare SRS with other treatment modalities like endovascular embolization and surgery.
Main Methods:
- The study discusses the application of SRS for DAVFs, particularly those without cortical vein drainage (CVD).
- It also considers SRS as a secondary treatment for residual DAVF components after initial interventions.
Main Results:
- SRS is a safe and effective option for less aggressive DAVFs, especially for symptom management (headache, bruit, ocular symptoms).
- For aggressive DAVFs with CVD, endovascular embolization or surgery is recommended initially.
- SRS can be used post-intervention to manage residual DAVF components, offering a gradual obliteration.
Conclusions:
- Stereotactic radiosurgery is a valuable, minimally invasive treatment for specific intracranial dural arteriovenous fistulas.
- While SRS has a longer latency period, it mitigates risks of venous hypertension and infarction associated with immediate interventions.
