Parasagittal dural arteriovenous fistulas

Area of Science:

• Neurosurgery
• Interventional Radiology
• Vascular Neurology

Background:

• Parasagittal dural arteriovenous fistulas (DAVFs) are often underrepresented in literature due to small case series.
• Previous studies may have reporting bias, limiting understanding of these lesions.
• A large, sequential cohort study is needed to accurately assess parasagittal DAVFs.

Purpose of the Study:

• To present a comprehensive analysis of a large cohort of parasagittal DAVFs.
• To investigate the clinical manifestations, angioarchitecture, and outcomes of parasagittal DAVFs.
• To evaluate the efficacy and safety of treatment modalities for parasagittal DAVFs.

Main Methods:

• Retrospective analysis of 80 patients with parasagittal DAVFs treated between 2002 and 2022.
• Review of clinical data, angioarchitecture, and treatment outcomes.
• Categorization of treatments including trans-arterial embolization (TAE), surgery, and conservative management.

Main Results:

• Eighty patients presented with 85 parasagittal DAVFs; 69 men and 11 women, average age 50.5 years.
• Trans-arterial embolization (TAE) was the primary treatment (76 patients), achieving 94.9% immediate complete occlusion.
• A high cure rate of 96.2% was observed with TAE, with no major complications and symptom improvement in most patients.

Conclusions:

• Parasagittal DAVFs present a substantial risk of hemorrhage and neurological deficits.
• Trans-arterial embolization (TAE) is a highly effective and safe treatment for parasagittal DAVFs.
• This large cohort study supports TAE as a primary therapeutic option with excellent outcomes.