Surgical and Endovascular Treatments for Asymptomatic Arteriovenous Fistulas at the Craniocervical Junction : A Multicenter Study
Copyright © 2023 Elsevier Inc. All rights reserved..
OBJECTIVE: Asymptomatic craniocervical junction arteriovenous fistulas (CCJ AVFs) are rare and, thus, a consensus has not yet been reached regarding the indication of surgical interventions. This retrospective multicenter cohort study investigated the risks associated with surgery for asymptomatic CCJ AVFs and discussed the indication of surgical interventions.
METHODS: Using data from 111 consecutive patients with CCJ AVFs registered with the Neurospinal Society of Japan between 2009 and 2019, we analyzed the treatment, complications, and outcomes of 18 patients with asymptomatic CCJ AVF.
RESULTS: The median age of the patient cohort was 68 years (37-80 years), and there were 11 males and 7 females. Diagnoses were 14 patients with dural AVF, one perimedullary AVF, one radicular AVF, one epidural AVF, and one bilateral dural and epidural AVF. Initial treatment included direct surgery in 12 patients, endovascular treatment in four, and conservative treatment in two. Among 16 patients, three complications (18.7%) occurred: spinal cord infarction associated with the surgical procedure, cerebral infarction associated with intraoperative angiography, and mortal medullary hemorrhage after endovascular treatment followed by open surgery. Complete occlusion was achieved in all 12 patients in the direct surgery group and in one out of four in the endovascular treatment group.
CONCLUSIONS: Given the risk of serious complications associated with asymptomatic CCJ AVF and the fact that no case of asymptomatic CCJ AVF became symptomatic in this study, prophylactic surgery for asymptomatic CCJ AVF should be carefully considered.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:175 |
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| Enthalten in: |
World neurosurgery - 175(2023) vom: 15. Juli, Seite e1049-e1058 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Inoue, Tomoo [VerfasserIn] |
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| Links: |
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| Themen: |
Arteriovenous fistula |
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| Anmerkungen: |
Date Completed 28.06.2023 Date Revised 28.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.wneu.2023.04.068 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM355907585 |
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| 100 | 1 | |a Inoue, Tomoo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Surgical and Endovascular Treatments for Asymptomatic Arteriovenous Fistulas at the Craniocervical Junction |b A Multicenter Study |
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| 500 | |a Date Completed 28.06.2023 | ||
| 500 | |a Date Revised 28.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: Asymptomatic craniocervical junction arteriovenous fistulas (CCJ AVFs) are rare and, thus, a consensus has not yet been reached regarding the indication of surgical interventions. This retrospective multicenter cohort study investigated the risks associated with surgery for asymptomatic CCJ AVFs and discussed the indication of surgical interventions | ||
| 520 | |a METHODS: Using data from 111 consecutive patients with CCJ AVFs registered with the Neurospinal Society of Japan between 2009 and 2019, we analyzed the treatment, complications, and outcomes of 18 patients with asymptomatic CCJ AVF | ||
| 520 | |a RESULTS: The median age of the patient cohort was 68 years (37-80 years), and there were 11 males and 7 females. Diagnoses were 14 patients with dural AVF, one perimedullary AVF, one radicular AVF, one epidural AVF, and one bilateral dural and epidural AVF. Initial treatment included direct surgery in 12 patients, endovascular treatment in four, and conservative treatment in two. Among 16 patients, three complications (18.7%) occurred: spinal cord infarction associated with the surgical procedure, cerebral infarction associated with intraoperative angiography, and mortal medullary hemorrhage after endovascular treatment followed by open surgery. Complete occlusion was achieved in all 12 patients in the direct surgery group and in one out of four in the endovascular treatment group | ||
| 520 | |a CONCLUSIONS: Given the risk of serious complications associated with asymptomatic CCJ AVF and the fact that no case of asymptomatic CCJ AVF became symptomatic in this study, prophylactic surgery for asymptomatic CCJ AVF should be carefully considered | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Arteriovenous fistula | |
| 650 | 4 | |a Asymptomatic | |
| 650 | 4 | |a Craniocervical junction | |
| 650 | 4 | |a Endovascular embolization | |
| 650 | 4 | |a Surgery | |
| 700 | 1 | |a Endo, Toshiki |e verfasserin |4 aut | |
| 700 | 1 | |a Takai, Keisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Seki, Toshitaka |e verfasserin |4 aut | |
| 700 | 0 | |a Neurospinal Society of Japan CCJ AVF study investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Ito, Keisuke |e investigator |4 oth | |
| 700 | 1 | |a Iwasaki, Motoyuki |e investigator |4 oth | |
| 700 | 1 | |a Uchikado, Hisaaki |e investigator |4 oth | |
| 700 | 1 | |a Umebayashi, Daisuke |e investigator |4 oth | |
| 700 | 1 | |a Otsuka, Munehiro |e investigator |4 oth | |
| 700 | 1 | |a Ohtonari, Tatsuya |e investigator |4 oth | |
| 700 | 1 | |a Oda, Junpei |e investigator |4 oth | |
| 700 | 1 | |a Kageyama, Hiroto |e investigator |4 oth | |
| 700 | 1 | |a Kurokawa, Ryu |e investigator |4 oth | |
| 700 | 1 | |a Koyanagi, Izumi |e investigator |4 oth | |
| 700 | 1 | |a Koizumi, Satoshi |e investigator |4 oth | |
| 700 | 1 | |a Sugawara, Taku |e investigator |4 oth | |
| 700 | 1 | |a Takeshima, Yasuhiro |e investigator |4 oth | |
| 700 | 1 | |a Nagashima, Yoshitaka |e investigator |4 oth | |
| 700 | 1 | |a Nishikawa, Misao |e investigator |4 oth | |
| 700 | 1 | |a Fujimoto, Masashi |e investigator |4 oth | |
| 700 | 1 | |a Honda, Fumiaki |e investigator |4 oth | |
| 700 | 1 | |a Matsui, Seishi |e investigator |4 oth | |
| 700 | 1 | |a Matsumoto, Yoshihisa |e investigator |4 oth | |
| 700 | 1 | |a Mitsuhara, Takafumi |e investigator |4 oth | |
| 700 | 1 | |a Miyoshi, Yasuyuki |e investigator |4 oth | |
| 700 | 1 | |a Murata, Hidetoshi |e investigator |4 oth | |
| 700 | 1 | |a Yasuhara, Takao |e investigator |4 oth | |
| 700 | 1 | |a Yamahata, Hitoshi |e investigator |4 oth | |
| 700 | 1 | |a Yamamoto, Shinji |e investigator |4 oth | |
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