ArticleEmergency medicine international2025
Analysis of the Efficacy and Prognosis of Microsurgery and Transarterial Embolization in the Treatment of High-Grade Dural Arteriovenous Fistulas.
Article in Emergency medicine international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the surgical outcomes of microsurgical treatment and transarterial endovascular embolization for dural arteriovenous fistulas (DAVFs). Methods: A retrospective analysis was conducted on 47 patients diagnosed with high-grade DAVFs (Cognard types 2b, 2a + b, 3, 4, and 5) between June 2019 and June 2022 at Nanjing Brain Hospital, affiliated with Nanjing Medical University. These patients underwent either microsurgery or endovascular embolization. Postoperative efficacy, surgical complications, and related prognostic factors were compared between the two groups. The primary endpoint was a postoperative modified Rankin Scale (mRS) score > 3. Secondary outcomes included angiographic confirmation of fistula occlusion, complication rates, and neurological deficits. Results: In the microsurgical treatment group, complete fistula occlusion was achieved in 23 patients (85.185%), while 12 patients (60.000%) in the transarterial embolization group (single-session treatment) achieved complete occlusion. Although microsurgical treatment demonstrated a higher occlusion rate, this difference did not reach statistical significance ( Conclusion: Microsurgical treatment demonstrated a higher rate of complete fistula occlusion compared to single-session transarterial embolization in patients with DAVFs, although this difference was not statistically significant. Both treatment modalities showed acceptable safety profiles. Patients with single fistulas showed a lower risk of severe postoperative neurological deficits compared to those with multiple fistulas. This study provides important insights into the emergency treatment of DAVF. Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2300072890.
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