Observational studyActa neurochirurgica2019
Cranial dural arteriovenous shunts: selection of the ideal lesion for surgical occlusion according to the classification system.
Observational study in Acta neurochirurgica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Role and Efficacy of Direct Surgery in the Management of Intracranial Dural Arteriovenous Fistulas.Acta neurochirurgica. Supplement · 2025Article
- Article
- Isolated sinus dural arteriovenous fistulas: a single-center experience in 44 patients.Acta neurochirurgica · 2024Article
- The Challenging Clinical Management of Patients with Cranial Dural Arteriovenous Fistula and Secondary Parkinson's Syndrome: Pathophysiology and Treatment Options.Cerebrovascular diseases extra · 2020Review
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe types of cranial dural arteriovenous fistulae (cDAVFs) that constitute good surgical candidates are unclear despite the use of classifications. We aimed to compare the DES classification with other classification schemes in identifying "ideal lesions for surgery." The DES scheme is based on two features: the level of the shunt (BVS, bridging vein shunt; DSS, dural sinus shunt; ISS, isolated sinus shunt; EVS, emissary vein shunt) and the type of leptomeningeal venous reflux (LVR) (direct, exclusive, strained).
methodsIn this observational cohort study, the angiographies of 20 consecutive patients treated over 1 year were analyzed retrospectively. We defined cDAVFs as ideal for surgery, if cure may be achieved by disconnecting the arterialized draining vein through a single craniotomy. To evaluate the performance of each classification scheme in identifying the "ideal lesion for surgery," we carried out a sensitivity analysis of the Borden, Cognard, and DES schemes.
resultsEight lesions were Borden type 3 and 1 type 2, and 11 type 1. According to Cognard, 2 lesions were type IV, 2 type III, 1 type IIa+b, 11 type I, and 4 lesions could not be clearly classified. According to the DES scheme, 8 lesions were DSS, 4 BVS, 3 ISS, and 5 EVS. All 4 lesions classified as BVS in the DES were ideal lesions for surgery (sensitivity, specificity, PPV, NPV 100%). Not all high-grade lesions according to Borden were good surgical candidates.
conclusionThe DES scheme, as opposed to other classifications, facilitates the therapeutic decision-making especially for selecting candidates for surgery.
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