Risk of Early Versus Later Rebleeding From Dural Arteriovenous Fistulas With Cortical Venous Drainage

被引：4

作者：

Durnford, Andrew J. ^{[1
]}

Akarca, Danyal ^{[1
,3
]}

Culliford, David ^{[2
]}

Millar, John ^{[1
]}

Guniganti, Ridhima ^{[4
]}

Giordan, Enrico ^{[5
,6
]}

Brinjikji, Waleed ^{[5
,6
]}

Chen, Ching-Jen ^{[7
]}

Abecassis, Isaac Josh ^{[8
]}

Levitt, Michael ^{[8
,9
]}

Polifka, Adam J. ^{[10
]}

Derdeyn, Colin P. ^{[11
,12
]}

Samaniego, Edgar A. ^{[11
,12
]}

Kwasnicki, Amanda ^{[13
]}

Alaraj, Ali ^{[13
]}

Potgieser, Adriaan R. E. ^{[14
]}

Chen, Stephanie ^{[15
]}

Tada, Yoshiteru ^{[16
]}

Phelps, Ryan ^{[17
]}

Abla, Adib ^{[18
]}

Satomi, Junichiro ^{[7
]}

Starke, Robert M. ^{[15
]}

van Dijk, J. Marc C. ^{[7
,14
]}

Amin-Hanjani, Sepideh ^{[13
]}

Hayakawa, Minako ^{[11
,12
]}

Gross, Bradley ^{[18
]}

Fox, W. Christopher ^{[10
]}

Kim, Louis ^{[8
,9
]}

Sheehan, Jason ^{[16
]}

Lanzino, Giuseppe ^{[5
,6
]}

Kansagra, Akash P. ^{[19
]}

Du, Rose ^{[20
]}

Lai, Rosalind ^{[20
]}

Zipfel, Gregory J. ^{[4
]}

Bulters, Diederik O.

机构：

[1] Wessex Neurol Ctr, Southampton, Hants, England

[2] Univ Southampton, Univ Hosp Southampton, Southampton, Hants, England

[3] Univ Cambridge, MRC Cognit & Brain Sci Unit, Cambridge, England

[4] Washington Univ, Dept Neurol Surg, St Louis, MO 63110 USA

[5] Mayo Clin, Dept Neurol Surg, Rochester, MN USA

[6] Mayo Clin, Dept Radiol, Rochester, MN USA

[7] Univ Virginia, Dept Neurol Surg, Charlottesville, VA USA

[8] Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA

[9] Univ Washington, Stroke & Appl Neurosci Ctr, Seattle, WA 98195 USA

[10] Univ Florida, Dept Neurol Surg, Gainesville, FL USA

[11] Univ Iowa, Dept Neurol, Iowa City, IA 52242 USA

[12] Univ Iowa, Dept Radiol, Iowa City, IA 52242 USA

[13] Univ Illinois, Dept Neurol Surg, Chicago, IL USA

[14] Univ Med Ctr Groningen, Dept Neurol Surg, Groningen, Netherlands

[15] Univ Miami, Dept Neurol Surg, Coral Gables, FL 33124 USA

[16] Tokushima Univ, Inst Biomed Biosci, Grad Sch, Dept Neurosurg, Tokushima, Japan

[17] Univ Calif San Francisco, Weill Inst Neurosci, Dept Neurosurg, San Francisco, CA 94143 USA

[18] Univ Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15260 USA

[19] Washington Univ, Mallinckrodt Inst Radiol, St Louis, MO USA

[20] Brigham & Womens Hosp, Dept Neurosurg, 75 Francis St, Boston, MA 02115 USA

来源：

STROKE | 2022年 / 53卷 / 07期

关键词：

drainage; fistula; hemorrhage; incidence; natural history; NATURAL-HISTORY; MANAGEMENT; HEMORRHAGE;

D O I：

10.1161/STROKEAHA.121.036450

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Cranial dural arteriovenous fistulas with cortical venous drainage are rare lesions that can present with hemorrhage. A high rate of rebleeding in the early period following hemorrhage has been reported, but published long-term rates are much lower. No study has examined how risk of rebleeding changes over time. Our objective was to quantify the relative incidence of rebleeding in the early and later periods following hemorrhage. Methods: Patients with dural arteriovenous fistula and cortical venous drainage presenting with hemorrhage were identified from the multinational CONDOR (Consortium for Dural Fistula Outcomes Research) database. Natural history follow-up was defined as time from hemorrhage to first treatment, rebleed, or last follow-up. Rebleeding in the first 2 weeks and first year were compared using incidence rate ratio and difference. Results: Of 1077 patients, 250 met the inclusion criteria and had 95 cumulative person-years natural history follow-up. The overall annualized rebleed rate was 7.3% (95% CI, 3.2-14.5). The incidence rate of rebleeding in the first 2 weeks was 0.0011 per person-day; an early rebleed risk of 1.6% in the first 14 days (95% CI, 0.3-5.1). For the remainder of the first year, the incidence rate was 0.00015 per person-day; a rebleed rate of 5.3% (CI, 1.7-12.4) over 1 year. The incidence rate ratio was 7.3 (95% CI, 1.4-37.7; P, 0.026). Conclusions: The risk of rebleeding of a dural arteriovenous fistula with cortical venous drainage presenting with hemorrhage is increased in the first 2 weeks justifying early treatment. However, the magnitude of this increase may be considerably lower than previously thought. Treatment within 5 days was associated with a low rate of rebleeding and appears an appropriate timeframe.

引用

页码：2340 / 2345

页数：6

共 16 条

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