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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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Surgical Strategy for Ethmoidal Dural Arteriovenous Fistula
Tae Keun Jee1, Young Woon Lee1, Je Young Yeon1
1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
World Neurosurgery
|June 1, 2022
Summary
Surgical treatment for ethmoidal dural arteriovenous fistulas (DAVF) using a unilateral approach yields excellent outcomes. The lateral supraorbital approach is particularly effective for unilateral ethmoidal DAVF, with no reported recurrence.
Area of Science:
- Neurosurgery
- Vascular Surgery
Background:
- Ethmoidal dural arteriovenous fistula (DAVF) is a rare intracranial vascular malformation.
- Surgical management of ethmoidal DAVF presents unique challenges due to its complex anatomy.
Purpose of the Study:
- To evaluate the effectiveness of a unilateral surgical approach for treating ethmoidal DAVF.
- To analyze different surgical strategies and their outcomes in a cohort of patients.
Main Methods:
- Retrospective analysis of 19 patients with ethmoidal DAVF treated between 1999 and 2021.
- Surgical approaches included frontobasal, pterional, and lateral supraorbital techniques.
- Preoperative angiography and postoperative follow-up were used to assess outcomes.
Main Results:
- The lateral supraorbital approach was the most frequently used (47%) and had the shortest median procedural time (111 minutes).
- Complete obliteration of ethmoidal DAVF was achieved in all 19 patients, with no postoperative complications or recurrence reported in 68% over 12 months.
- Unilateral cortical draining veins were present in 95% of patients, supporting the efficacy of unilateral surgical strategies.
Conclusions:
- Surgical treatment for ethmoidal DAVF demonstrates excellent outcomes.
- The lateral supraorbital approach is an efficient option for unilateral ethmoidal DAVF.
- Thorough preoperative assessment for bilateral drainage is crucial for successful surgical planning.
