![]() ![]() In 12 fistulae the balloon could not be negotiated through the fistula and these fistulae were treated with transarterial coil occlusion. Detachable balloons were used in 79 fistulae. The patients were followed up at 1 month and then every 6 months thereafter. Treatment comprised transarterial balloon or coil embolizations. All patients had baseline brain CT or MR imaging. A total of 89 patients with a direct CCF were treated. We also describe the technique, symptomatology and complications associated with the procedure and report on the long-term follow-up in our treated patients. The purpose of this review was to evaluate the endovascular treatment of direct CCFs. Endovascular treatment of these lesions is challenging. It is concluded that these features significantly increase the natural risk of dural AVM's, and warrant a more vigilant therapeutic strategy.read more read lessĪbstract: Direct carotid-cavernous fistulae (CCFs) are type A fistulae according to Barrow’s classification. The latter three angiographic features often coexisted in the same dural AVM. Leptomeningeal venous drainage, variceal or aneurysmal venous dilations, and galenic drainage correlated significantly (p less than 0.05) with aggressive neurological presentation. low flow) did not correlate with aggressive neurological behavior as defined. Contralateral contribution to arterial supply and rate of shunting (high vs. ![]() No location of dural AVM's was immune from aggressive neurological behavior however, an aggressive neurological course was least often associated with cases involving the transverse-sigmoid sinuses and cavernous sinus and most often associated with cases at the tentorial incisura. The location and angiographic features of 100 aggressive cases were compared to those of 277 benign cases. In order to clarify features associated with aggressive behavior, a comprehensive meta-analysis was performed on 360 additional dural AVM's reported in the literature with sufficiently detailed clinical and angiographic information. Six of the seven cases without an aggressive neurological course were treated conservatively, and the seventh patient underwent embolization of a cavernous sinus dural AVM because of worsening ophthalmoplegia. One patient received embolization and radiation therapy without surgery. ![]() Six patients underwent surgical resection of their dural AVM, with preparatory embolization in two cases. Two of these 10 patients died prior to surgical intervention and a third was severely disabled by intracerebral hemorrhage. The authors present their clinical experience with 17 dural AVM's in adults, including 10 cases with an aggressive neurological course (strictly defined as hemorrhage or progressive focal neurological deficit other than ophthalmoplegia). Abstract: The natural history of cranial dural arteriovenous malformations (AVM's) is highly variable. ![]()
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