Efficacy and safety of neurointervention in anterior cranial fossa dural arteriovenous fistula: a comparative analysis of different vascular approaches
10.3760/cma.j.cn115354-20241113-00709
- VernacularTitle:不同血管入路栓塞前颅窝硬脑膜动静脉瘘的有效性和安全性分析
- Author:
Wenzhi GONG
1
;
Can LI
1
;
Xin FENG
1
;
Wenchao LIU
1
;
Runze GE
1
;
Chi HUANG
1
;
Jiwan HUANG
1
;
Ran LI
1
;
Shenquan GUO
1
;
Chuanzhi DUAN
1
;
Xifeng LI
1
Author Information
1. 南方医科大学珠江医院神经外科中心脑血管病外科，国家临床重点专科，脑血管病诊疗技术与器械教育部工程研究中心，广东省普通高校脑功能修复与再生重点实验室，脑科学与脑智能研究院，广州 510282
- Publication Type:Journal Article
- Keywords:
Dural arteriovenous fistula;
Anterior cranial fossa;
Neurointervention
- From:
Chinese Journal of Neuromedicine
2025;24(3):224-229
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of embolization of anterior cranial fossa dural arteriovenous fistula (ACF-DAVF) via different arterial approaches, and provide evidence for individualized treatment of ACF-DAVF. Methods:A retrospective study was performed; 25 patients with ACF-DAVF admitted to Department of Cerebrovascular Surgery, Neurosurgery Center, Zhujiang Hospital, Southern Medical University from January 2020 to December 2023 were enrolled. Vascular approaches, including the anterior cerebral artery ( n=7), facial artery ( n=3), middle meningeal artery ( n=8), ophthalmic artery ( n=6), and vein ( n=1), were selected based on angioarchitectural features and microcatheter accessibility. Fistula and proximal draining vein occlusions were confirmed by immediate post-embolization digital subtraction angiography (DSA), and perioperative complications were recorded. At a 6-month follow-up, prognoses were assessed by modified Rankin Scale (mRS), and DSA or MRA was performed to detect the recurrence of ACF-DAVF. Results:Six patients had complete embolization and 2 patients had near-total embolization of the fistula and proximal draining vein immediately after embolization via middle meningeal artery approach; 4 patients achieved complete embolization and 2 patients achieved near-total embolization via ophthalmic artery approach; 6 patients achieved complete embolization and one patient achieved near-total embolization via anterior cerebral artery approach; 3 patients achieved complete embolization via facial artery approach; one patient achieved complete embolization via venous approach. No perioperative intracranial hemorrhage or central retinal artery occlusion was noted. Follow-up for 6 months was performed in 25 patients: mRS score was 0 in 19 patients, 1 in 2 patients, and 2 in 4 patients; DSA in 19 patients and MRA in 6 patients indicated no ACF-DAVF recurrence. Conclusion:Based on the angioarchitectural features and microcatheter accessibility, individualized selection of vascular approaches for ACF-DAVF embolization can achieve better efficacy and safety.
