Dural arteriovenous fistulas at the craniocervical junction: a systematic review and meta-analysis

被引:1
作者
Qedair, Jumanah [1 ,2 ]
Sankarappan, Kiran [3 ]
Eraghi, Mohammad Mirahmadi [4 ,5 ]
Gersey, Zachary C. [6 ]
Agarwal, Prateek [6 ]
Anand, Sharath Kumar [6 ]
Palmisciano, Paolo [7 ]
Blackwell, Matthew [8 ]
Maroufi, Seyed Farzad [9 ]
Aoun, Salah G. [10 ]
El Ahmadieh, Tarek Y. [11 ]
Cohen-Gadol, Aaron A. [12 ]
Bin-Alamer, Othman [11 ]
机构
[1] King Saud Bin Abdulaziz Univ Hlth Sci KSAU HS, Coll Med, Jeddah, Saudi Arabia
[2] King Abdullah Int Med Res Ctr KAIMRC, Jeddah, Saudi Arabia
[3] Texas A&M Univ, Coll Med, Houston, TX USA
[4] Islamic Azad Univ, Sch Med, Qeshm Int Branch, Qeshm, Iran
[5] Islamic Azad Univ, Student Res Comm, Sch Med, Qeshm Int Branch, Qeshm, Iran
[6] Univ Pittsburgh, Med Ctr, Dept Neurol Surg, Pittsburgh, PA USA
[7] Univ Calif Davis, Dept Neurol Surg, Sacramento, CA USA
[8] Indiana Univ Sch Med, Indianapolis, IN USA
[9] Univ Tehran Med Sci, Dept Neurosurg, Tehran, Iran
[10] Univ Texas Southwestern Med Ctr Dallas, Dept Neurol Surg, Dallas, TX USA
[11] Loma Linda Univ, Med Ctr, Dept Neurosurg, 11234 Anderson St, Loma Linda, CA 92354 USA
[12] USC, Dept Neurol Surg, Keck Sch Med, Los Angeles, CA USA
关键词
Dural arteriovenous fistulas; DAVFs; Craniocervical junction; Microsurgery; Embolization; Fistula obliteration; ENDOVASCULAR TREATMENT; OBLITERATION; MICROSURGERY; ANATOMY;
D O I
10.1007/s10143-024-03018-3
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BackgroundThe management for craniocervical junction dural arteriovenous fistulas (CCJ-DAVFs) remains controversial and clinically challenging. We systemically summarized the clinical and angiographic outcomes of microsurgery, embolization, and conservative management.MethodsRelevant articles were retrieved from PubMed, Scopus, Web of Science, and Cochrane, following PRISMA guidelines. A systematic review and meta-analysis were conducted on the clinical characteristics, management approaches, and clinical and angiographic outcomes.ResultsWe included 13 articles (166 patients). The weighted mean age was 58.9 years (95%CI: 53.2-64.5), 58.8 years (95%CI: 48.4-69.2), and 63.8 years (95%CI: 60.1-67.5), in microsurgery, embolization, and conservative groups respectively, with an overall male sex predominance (microsurgery [n = 51/77, 66.2%], embolization [n = 44/56, 78.6%], and conservative management [n = 6/8, 75.0%]). Patients were managed with microsurgery (n = 80/172, 46.5%), embolization (n = 79/172, 45.9%), and conservative treatment (n = 13/172, 7.6%). Foramen magnum was the most common location (microsurgery [n = 34/77, 44.2%], embolization [n = 31/56, 55.4%], and conservative treatment [n = 3/8, 37.5%]). Vertebral artery was the primary feeder (microsurgery [n = 58/84, 69.1%], embolization [n = 41/86, 47.6%], and conservative treatment [n = 4/7, 57.1%]). Complete fistula obliteration rates were 74.1% (95%CI:52.3-88.2%) in the microsurgery group and 54.9% (95%CI:30.7-77.0%) in the embolization group. Complications rates were 16.2% (95%CI:6.7-34.5%) in the embolization group, 11.6% (95%CI:3.8-30.4%) in the microsurgery group, and 7.7% (95%CI:1.1-39.1%) in the conservative group. Different rates of good clinical outcomes were observed [microsurgery: 66.4% (95%CI:48.1-80.8%), embolization: 51.9% (95%CI:30.8-72.4%), and conservative: 11.6% (95%CI:4.4-27.4%)].ConclusionsIn patients with CCJ-DAVFs, each management approach has its own merits based on the fistula and patient characteristics.
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页数:12
相关论文
共 54 条
[1]  
Anatomical Basis of Surgical Approaches to the Region of the Foramen Magnum, 2013, Surgery of the Craniovertebral Junction, DOI [10.1055/B-0034-84433, DOI 10.1055/B-0034-84433]
[2]  
Bernard F, 2017, INTERDISCIP NEUROSUR, V9, P48, DOI 10.1016/j.inat.2017.03.003
[3]   Long-term follow-up of transarterial balloon-assisted Onyx embolization for endovascular treatment of dural arteriovenous fistulas: A single-institution case series and literature review [J].
Cai, Heng ;
Chen, Liangyu ;
Zhang, Nan ;
Tang, Wei ;
Yang, Fangyu ;
Li, Zhiqing .
CLINICAL NEUROLOGY AND NEUROSURGERY, 2020, 199
[4]   Endovascular treatment strategy, technique, and outcomes for dural arteriovenous fistulas of the marginal sinus region [J].
Caton, Michael Travis ;
Narsinh, Kazim H. ;
Baker, Amanda ;
Hetts, Steven W. ;
Cooke, Daniel L. ;
Higashida, Randall T. ;
Dowd, Christopher F. ;
Halbach, Van V. ;
Amans, Matthew R. .
JOURNAL OF NEUROINTERVENTIONAL SURGERY, 2022, 14 (02) :155-+
[5]  
cebm.ox.ac, 2023, OCEBM Levels of Evidence-Centre for Evidence-Based Medicine (CEBM)
[6]  
Chen G, 2011, ACTA NEUROCHIR SUPPL, V110, P99, DOI 10.1007/978-3-7091-0356-2_18
[7]   Treatment of Dural Arteriovenous Fistula with Intradural Draining Vein at the Craniocervical Junction: Case Series with Special Reference to the Anatomical Considerations [J].
Choi, June Ho ;
Park, Jung Cheol ;
Ahn, Jae Sung ;
Park, Wonhyoung .
WORLD NEUROSURGERY, 2023, 175 :E1226-E1236
[8]   Anatomical Variation in Morphometry and Morphology of the Foramen Magnum and Occipital Condyle in Dried Adult Skulls [J].
Degno, Sisay ;
Abrha, Mueez ;
Asmare, Yared ;
Muche, Abebe .
JOURNAL OF CRANIOFACIAL SURGERY, 2019, 30 (01) :256-259
[9]   MICROSURGICAL ANATOMY OF THE REGION OF THE FORAMEN MAGNUM [J].
DEOLIVEIRA, E ;
RHOTON, AL ;
PEACE, D .
SURGICAL NEUROLOGY, 1985, 24 (03) :293-352
[10]   Transarterial Embolization of Cavernous Sinus Dural Arteriovenous Fistulas with Ipsilateral Inferior Petrosal Sinus Occlusion via the Ascending Pharyngeal Artery [J].
Fang, Bing ;
Qian, Cong ;
Yu, Jun ;
Xu, Liang ;
Jiang, Dingyao ;
Xu, Jing ;
Zhang, Jianmin ;
Chen, Gao .
WORLD NEUROSURGERY, 2018, 117 :E603-E611