gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Treatment of intracranial dural arteriovenous-fistulas: A comparison of surgical versus endovascular therapy

Meeting Abstract

  • K. Jähne - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig
  • D. Fritzsch - Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Abteilung für Neuroradiologie, Universitätsklinikum Leipzig, Leipzig
  • J. Meixensberger - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig
  • C. Renner - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Leipzig, Leipzig

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.10.11

DOI: 10.3205/11dgnc076, URN: urn:nbn:de:0183-11dgnc0769

Published: April 28, 2011

© 2011 Jähne et al.
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Outline

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Objective: A comparison of the clinical and radiological outcome after surgical or endovascular therapy of intracranial dural arteriovenous-fistulas (DAV-fistulas).

Methods: A retrospective analysis of 20 patients with an intracranial DAV fistula between 2003 and 2010 with respect to radiological and clinical outcome.

Results: According to the Cognard classification, 1 patient (5%) had type I, 5 patients (25%) had type IIb, 4 patients (20%) had type III, 9 patients (45%) had type IV and 1 patient (5%) had type V DAV. 10 of these patients were primarily treated by an endovascular approach with complete closure in 5 cases. 10 patients had a primary surgical treatment with complete closure in 7 cases. Thus, in 8 patients the initial closure of the fistula was incomplete. These patients underwent a secondary surgical therapy with complete closure. There was no difference in clinical outcome between both therapy modalities if an initial closure of the fistula was achieved. All patients showed neurological improvement in case of complete closure of the fistulas.

Conclusions: A higher rate of successful closure could be achieved in the primarily surgically treated cases. All patients who showed an incomplete closure of the fistula were successfully treated by a secondary surgical procedure. Therefore, a primary surgical treatment for intracranial DAVs is recommended.