Classification, angioarchitecture and treatment outcomes of medullary bridging vein-draining dural arteriovenous fistulas in the foramen magnum region: a multicenter study.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-10-12 DOI:10.1007/s00234-024-03478-w

Tomohiko Ozaki, Masafumi Hiramatsu, Hajime Nakamura, Yasunari Niimi, Shuichi Tanoue, Katsuhiro Mizutani, Ichiro Nakahara, Yuji Matsumaru, Yasushi Matsumoto, Timo Krings, Toshiyuki Fujinaka

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Abstract

Purpose: This study aimed to classify medullary bridging vein-draining dural arteriovenous fistulas (MBV-DAVFs) located around the foramen magnum (FM) according to their location and characterize their angioarchitecture and treatment outcomes.

Methods: Patients with MBV-DAVFs diagnosed between January 2013 and October 2022 were included. MBV-DAVFs were classified into four groups. Jugular vein-bridging vein (JV-BV) DAVF: located in proximity to jugular fossa, Anterior condylar vein (ACV)-BV DAVF: proximity to anterior condylar canal, Marginal sinus (MS)-BV DAVF: lateral surface of FM and Suboccipital cavernous sinus (SCS)-BV DAVF: proximity to dural penetration of vertebral artery.

Results: Twenty patients were included, three JV-BV, four ACV-BV, three MS-BV and ten SCS-BV DAVFs, respectively. All groups showed male predominance. There were significant differences in main feeders between JV (jugular branch of ascending pharyngeal artery) and SCS group (C1 dural branch). Pial feeders from anterior spinal artery (ASA) or lateral spinal artery (LSA) were visualized in four SCS and one MS group. Drainage pattern did not differ between groups. Transarterial embolization (TAE) was performed in three, two, one and two cases and complete obliteration was obtained in 100%, 50%, 100% and 0% in JV, ACS, MS and SCS group, respectively. Successful interventions without major complications were finally obtained in 100%, 75%, 100%, and 40% in JV, ACS, MS and SCS group, respectively.

Conclusion: JV-BV DAVFs were successfully treated using TAE alone. SCS-BV DAVFs were mainly fed by small C1 dural branches of vertebral artery often with pial feeders from ASA or LSA, and difficultly treated by TAE alone.

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枕骨大孔区髓质桥状静脉引流硬脑膜动静脉瘘的分类、血管结构和治疗效果：一项多中心研究。

目的：本研究旨在根据位于枕骨大孔（FM）周围的髓桥静脉引流硬脑膜动静脉瘘（MBV-DAVFs）的位置对其进行分类，并分析其血管结构和治疗效果：纳入2013年1月至2022年10月期间确诊的MBV-DAVFs患者。MBV-DAVF分为四组。颈静脉-桥接静脉（JV-BV）DAVF：位于颈静脉窝附近；髁前静脉（ACV）-BV DAVF：位于髁前管附近；边缘窦（MS）-BV DAVF：位于FM的外侧表面；枕下海绵窦（SCS）-BV DAVF：位于椎动脉硬膜穿出附近：共纳入 20 例患者，分别为 3 例 JV-BV、4 例 ACV-BV、3 例 MS-BV 和 10 例 SCS-BV DAVF。所有组别均以男性为主。JV组（咽升动脉颈静脉分支）和SCS组（C1硬膜分支）的主要供血来源存在明显差异。脊髓前动脉（ASA）或脊髓外侧动脉（LSA）的皮质馈源在四组 SCS 和一组 MS 中均可见。各组间的引流模式没有差异。经动脉栓塞术（TAE）分别在 JV 组、ACS 组、MS 组和 SCS 组的 3 例、2 例、1 例和 2 例病例中实施，完全阻塞率分别为 100%、50%、100% 和 0%。JV组、ACS组、MS组和SCS组最终分别有100%、75%、100%和40%的患者成功介入，且无重大并发症：结论：单纯使用 TAE 成功治疗了 JV-BV DAVF。结论：JV-BV DAVF 单纯使用 TAE 治疗成功，SCS-BV DAVF 主要由椎动脉的 C1 硬膜小分支供血，通常伴有来自 ASA 或 LSA 的皮质供血，单纯使用 TAE 难以治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464