Iampreechakul Prasert, Wangtanaphat Korrapakc, Chuntaroj Songpol, Angsusing Chonlada, Wattanasen Yodkhwan, Hangsapruek Sunisa, Lertbusayanukul Punjama, Siriwimonmas Somkiet
Department of Neurosurgery, Neurological Institute of Thailand, Bangkok, Thailand.
Department of Neuroradiology, Neurological Institute of Thailand, Bangkok, Thailand.
World Neurosurg X. 2024 Mar 1;22:100307. doi: 10.1016/j.wnsx.2024.100307. eCollection 2024 Apr.
The development of new dural arteriovenous fistulas (DAVFs) at another location following endovascular treatment of cavernous sinus DAVFs (CSDAVFs) are extremely rare. Our aim is to review cases of de Novo DAVFs that occurred after treatment of CSDAVFs at our institution and those reported in the literature.
We reviewed all cases of CSDAVFs evaluated by 2 experienced neuroradiologists. A literature search was performed using the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines focusing on De Novo DAVFs following the endovascular treatment of cerebrovascular malformations. Addition articles were searched through the reference lists of the included articles.
From June 2004 and September 2019., we identified 3 (2.5%) cases of De Novo DAVFs occurred after endovascular treatment or spontaneous obliteration of CSDAVFs from 119 treated CSDAVFs at our institute. Our review yielded 9 articles involving 12 patients with 15 de novo DAVFs, including our 3 patients. The mean age was 55.08 ± 12.9 years (range 43-69), 83.3% were females ( = 10). The new remote DAVFs occurred after endovascular treatment of CSDAVFs in 10 (83.3%) patients. The de novo DAVFs occurred following spontaneous complete regression in 2 (16.7%) patients. All de novo DAVFs developed after complete obliteration of treated CSDAVFs.
Sinus thrombosis and elevated venous pressure may play an important role in the pathogenesis of a de novo DAVF formation. In addition, thrombophilic abnormalities and the use of contraceptives may contribute to sinus thrombosis, leading to the development of the second remote DAVF after treatment of CSDAVFs.
海绵窦区硬脑膜动静脉瘘（CSDAVFs）血管内治疗后在其他部位出现新的硬脑膜动静脉瘘（DAVFs）极为罕见。我们的目的是回顾在我们机构治疗CSDAVFs后发生的新发DAVFs病例以及文献中报道的病例。
我们回顾了由2名经验丰富的神经放射科医生评估的所有CSDAVFs病例。使用PRISMA（系统评价和荟萃分析的首选报告项目）指南进行文献检索，重点关注脑血管畸形血管内治疗后新发的DAVFs。通过纳入文章的参考文献列表搜索其他文章。
从2004年6月至2019年9月，我们在我院119例接受治疗的CSDAVFs中，发现3例（2.5%）在血管内治疗或CSDAVFs自发闭塞后出现新发DAVFs。我们的综述产生了9篇文章，涉及12例患者共15例新发DAVFs，包括我们的3例患者。平均年龄为55.08±12.9岁（范围43 - 69岁），83.3%为女性（n = 10）。10例（83.3%）患者在CSDAVFs血管内治疗后出现新的远处DAVFs。2例（16.7%）患者在自发完全消退后出现新发DAVFs。所有新发DAVFs均在治疗的CSDAVFs完全闭塞后出现。
窦血栓形成和静脉压升高可能在新发DAVF形成的发病机制中起重要作用。此外，血栓形成倾向异常和避孕药的使用可能导致窦血栓形成，从而在CSDAVFs治疗后导致第二个远处DAVF的发生。
