Artikel
Incidence of thrombophilic abnormalities in patients with cranial dural arteriovenous fistulae in comparison to patients with spinal dural arteriovenous fistulae
Inzidenz von Gerinnungsstörungen bei Patienten mit kranialen arteriovenösen Malformationen im Vergleich zu Patienten mit spinalen arteriovenösen Malformationen
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Veröffentlicht: | 11. April 2007 |
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Objective: This study evaluates the incidence of thrombophilic abnormalities in patients with cranial dural ateriovenous fistulae (DAVF) in comparison to patients with spinal DAVF.
Methods: A total of 25 patients with cranial DAVF and 22 patients with spinal DAVF were included in this study. Blood samples were analyzed for factor V Leiden mutation, resistance to activated protein C and 20210A mutation of the prothrombin gene. The occurrence of lupus antiphospholipid and cardiolipin antibodies were also screened together with routine coagulation parameters (platelets, INR, fibrinogen) and extended tests (Textarin time, antithrombin, protein C and S activity, von Willebrand factor antigen, Ristocetin cofactor activity, D-Dimer and coagulation factor VIII activity).
Results: In 8 (32%) of the 25 patients with cranial DAVF thrombophilic risk factors were found. 4 patients had a heterozygote 20210A mutation of factor II and 2 patients had a heterozygote factor V Leiden mutation. In comparison only 1 (4.5%) patient of 22 suffering a spinal DAVF showed a thrombophilic risk factor (factor V Leiden mutation). Additionally 4 (16%) of 25 patients with cranial DAVF had deficient protein C activity in comparison to 1 (4.5%) of 22 patients with spinal DAVF. Cardiolipin antibodies were detected in 3/25 patients (12%) with cranial DAVF and were not found in patients with spinal DAVF.
Conclusions: This study showed a significant higher incidence of thrombophilic abnormalities in patients with cranial DAVF in comparison to patients with spinal DAVF. These results should be considered during treatment of patients with cranial DAVF while they don not seem to occur in patients with spinal DAVF to a similar rate. Further studies are necessary to understand the physiopathologic mechanisms of this distinct incidence of thrombophilic abnormalities in patients with cranial and spinal DAVF.