WITHDRAWN: Modified Borden Grading System For Cranial And Spinal Dural Arteriovenous Fistulas In Neuroendovsacular Era

Abstract

Objective:Dural arteriovenous fistulas (DAVFs) is a complex condition in neurovascular surgery. Many DAVF classifications have been reported and have changed over time in the literatures. The purposes of this study was to propose a practical and easy-to-follow grading system for DAVFs.Methods: From a retrospective analysis of our database, 143 DAVF patients were consecutively collected. Patients were grouped into modified Borden types I, II and III. Patients’ characteristics, treatment and outcomes were analyzed between 3 types. Patients’ pre-treatment status(pre-mRS) were analyzed between Borden, Cognard and modified Borden grading systems. Results:Male and non-sinus locations were statistically significantly correlated with the type III DAVF type (p<0.001). More than 3 pedical suppliers and pial arterial suppliers were associated with high grade (type II and III) DAVFs(p=0.003). Worse symptoms were present in most type II and type III patients(p<0.001). Type III DAVF was associated with TAE and type II DAVF was associated with TVE treatment modalities(p<0.001). The results of one-way ANOVA indicated that pre-mRS was significantly different within modified Borden types and Cognard types (p = 4.3×10-6 and p = 1×10-4, respectively). In terms of pre-mRS, patients were not separated well using Cognard grading systems.Conclusions: A modified grading system of cerebral and spinal DAVFs was promoted according to understanding of angioarchitectures in order to evaluate risk of DAVFs and guide the therapies of these lesions. The modified Borden grading system was informative by providing an effective assessment for the risk of patients with simple but precise results.