Johnson Catherine S, Chiu Albert, Cheung Andrew, Wenderoth Jason
C/o Dr Jason Wenderoth, PO Box 663, Randwick, NSW 2031, Australia.
Prince of Wales Private Hospital, Prince of Wales Hospital, Liverpool Hospital, Sydney Neurointerventional Specialists (SNIS), Suite 19, Level 7, Randwick NSW 2031, Australia.
J Clin Neurosci. 2018 Mar;49:62-70. doi: 10.1016/j.jocn.2017.12.007. Epub 2017 Dec 29.
Endovascular management of dural arteriovenous fistulas has become a mainstay of treatment. In particular, modern techniques have allowed greater fistula penetration and likelihood of complete obliteration. However, the efficacy of newer agents has not been quantified outside of predominantly small case reports and case series. Furthermore, the Australian experience with fistula embolization has yet to be reported in the literature. To this aim, we performed a retrospective review of our endovascular management of a large cohort of cranial dural arteriovenous fistulas in the liquid embolic era. This retrospective case series included ninety-six consecutive patients of any Cognard grade, treated between 2005 and 2016. Liquid embolic agents were used exclusively in eighty-three cases. The overall complete obliteration rate was 89.6% with a residual fistula rate of 2%, and complication rate of 8.3%. This Sydney, Australia cohort demonstrates excellent treatment effect and safety outcomes and thus supports the primary treatment of this condition by endovascular means.
硬脑膜动静脉瘘的血管内治疗已成为主要的治疗方法。特别是，现代技术使得对瘘管的穿透性更强，完全闭塞的可能性更大。然而，除了主要是小型病例报告和病例系列外，新型药物的疗效尚未得到量化。此外，澳大利亚在瘘管栓塞方面的经验尚未见文献报道。为此，我们对液体栓塞时代大量颅硬脑膜动静脉瘘的血管内治疗进行了回顾性研究。这个回顾性病例系列包括2005年至2016年间连续治疗的96例任何Cognard分级的患者。83例仅使用了液体栓塞剂。总体完全闭塞率为89.6%，残余瘘管率为2%，并发症发生率为8.3%。澳大利亚悉尼的这个队列显示出了优异的治疗效果和安全性结果，因此支持通过血管内手段对这种疾病进行主要治疗。
