Successful surgical treatment of a large mixed pial-dural arteriovenous malformation

Shima, Takeshi; Yamane, Kanji; Nishida, Minekatsu; Hatayama, Toru; Yamanaka, Chie

doi:10.1054/jocn.2000.0706

Cited by 2 publications

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References 3 publications

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“…The treatment of DPAVMs usually requires a combination of three therapeutic modalities, including endovascular therapy, microsurgery and stereotactic radiosurgery. The cure rate is extremely low, and morbidity and mortality is high [ 6 , 7 ]. Moreover, ARUBA showed that medical management is superior to medical management with interventional therapy for the prevention of death or stroke in patients with unruptured CAVMs [ 8 ].…”

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confidence: 99%

Embolization of feeding arteries and symptom alleviation of mixed dural-pial arteriovenous malformations

et al. 2018

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Background: To examine whether embolization of dural or pial blood supply branch is more efficient for symptom alleviation for unruptured mixed dural-pial arteriovenous malformations (DPAVMs). Methods: We retrospectively reviewed 30 DPAVM patients from a database of 425 consecutive cerebral arteriovenous malformation (CAVM) patients who underwent endovascular embolization between January 2010 and December 2015 at our institution. Demographics, angioarchitectural characteristics, endovascular embolization details and patients clinical outcomes were recorded. The modified Rankin Scale (mRS), Engel's classification and Visual Analogue pain scale (VAS) were used to assess clinical outcomes. Results: The single center cohort data shows that the incidence of DPAVM is 7.1%. Among the 30 DPAVM patients, 9 (30.0%) are ruptured and 21 (70.0%) are unruptured. Four (19.0%) of the 21 unruptured DPAVM patients are failed to follow-up, leaving 17 to analysis the clinical outcomes. Clinical presentations of the 17 unruptured DPAVM patients are epilepsy (n = 10), headache (n = 5) and focal neurological dysfunction (n = 2). Six patients have DPAVMs occluded via pial blood supply branches, 4 via dural branches and 7 via both pial and dural branches. Unruptured DPAVM patients with nidus occluded via dural blood supply branches, or both pial and dural branches have higher symptom alleviation rate than patients with nidus occluded via pial branches (100%/85.7% vs 66.7%). Conclusions: For DPAVM patients presented with epilepsy, headache and FND, embolization via dural blood supply branches may be more efficient for symptom alleviation. Large cohort study is needed to confirm the generalizability.

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Section: Introductionmentioning

confidence: 99%

Embolization of feeding arteries and symptom alleviation of mixed dural-pial arteriovenous malformations

et al. 2018

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Brain arteriovenous malformation with transdural blood supply: Current status (Review)

Piao

Guo

et al. 2019

Exp Ther Med

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Arterial blood supply to a brain arteriovenous malformation (BAVM) is mainly derived from the internal carotid artery (ICA) and vertebral basilar artery (VBA) system. However, in certain cases, arteries supplying the meninges may also contribute to the blood supply of the BAVM, resulting in the formation of a BAVM with transdural blood supply (TBS). To review the current status of BAVM with TBS, a literature search was performed in the PubMed database. Articles were screened for relevance and suitability of data. According to recent studies, the mechanisms by which TBS to a BAVM forms are mainly classified into the congenital and acquired type. BAVM with TBS is common in elderly patients and is characterized by intracranial hemorrhage, epilepsy, chronic headache and increased intracranial pressure. Digital subtraction angiography is the gold standard for diagnosing BAVM with TBS. Superselective angiography is also important. Treatments for BAVM with TBS include surgical resection, endovascular treatment (EVT), stereotactic radiosurgery and combined treatment. Surgical resection is difficult to perform. EVT has become the major therapy for treating BAVM with TBS due to its low procedural invasiveness. Combination of surgical resection and EVT may be a good option. In addition, stereotactic radiosurgery is frequently used as a complementary treatment to surgical and endovascular interventions. The prognosis of BAVM with TBS is not favorable, as the defect involves a complex arterial supply system.

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Successful surgical treatment of a large mixed pial-dural arteriovenous malformation

Cited by 2 publications

References 3 publications

Embolization of feeding arteries and symptom alleviation of mixed dural-pial arteriovenous malformations

Embolization of feeding arteries and symptom alleviation of mixed dural-pial arteriovenous malformations

Brain arteriovenous malformation with transdural blood supply: Current status (Review)

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