Repeated stereotactic radiosurgery for residual intracranial dural arteriovenous fistulas

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2025-04-29 DOI:10.1007/s00701-025-06536-1

Tzu-Chiang Peng, Chun-Fu Lin, Ai Seon Kuan, Hsiu-Mei Wu, Cheng-Chia Lee, Chung-Jung Lin, Huai-Che Yang

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引用次数: 0

Abstract

Objective

Stereotactic radiosurgery (SRS) is widely used for the treatment of intracranial dural arteriovenous fistulas (DAVFs); however, the outcomes of repeated SRS to deal with residual DAVFs are unclear. This study assessed the benefits and potential negative consequences of repeated SRS in patients with residual DAVFs.

Methods

This retrospective study examined all patients who underwent two SRS procedures for DAVFs in a single academic medical center between January 1998 and December 2022. Information related to patient demography, DAVFs characteristics, and clinical outcomes were obtained from medical records. The objective in this study was to obtain a preliminary overview of the results of repeated SRS for DAVFs.

Results

The study cohort of 19 patients included 14 patients with non-cavernous sinus (NCS) DAVFs and 5 patients with cavernous sinus (CS) DAVFs. The NCS group included 8 patients who were categorized as low-grade (Borden grade 1) and 6 as high-grade (Borden grade 2 or 3). The median follow up duration after the second session of SRS was 37 months. Symptomatic improvement was noted in 16 patients (84.2%) and total obliteration was identified in 11 patients (57.9%). No patient suffered from intracranial hemorrhage after the repeated SRS. One patient (5.3%) experienced symptomatic radiation-induced change mandating temporary course of medical treatment.

Conclusions

Repeated SRS appears to be a safe and effective approach to deal with residual DAVFs, resulting in symptomatic improvement and complete radiologic obliteration.

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反复立体定向放射手术治疗颅内残余硬脑膜动静脉瘘

目的定向放射外科（SRS）广泛应用于颅内硬膜动静脉瘘（DAVFs）的治疗；然而，重复SRS处理残留davf的结果尚不清楚。本研究评估了残留davf患者重复SRS的益处和潜在的负面后果。方法回顾性分析1998年1月至2022年12月在同一学术医疗中心接受两次SRS手术治疗davf的所有患者。从医疗记录中获得与患者人口统计学、davf特征和临床结果相关的信息。本研究的目的是获得davf重复SRS结果的初步概述。结果19例患者的研究队列包括14例非海绵窦（NCS） DAVFs和5例海绵窦（CS） DAVFs。NCS组包括8例低级别（Borden 1级）和6例高级别（Borden 2级或3级）患者。第二次SRS后的中位随访时间为37个月。16例（84.2%）患者症状改善，11例（57.9%）患者症状完全消失。重复SRS后无颅内出血。1例患者（5.3%）出现放射引起的症状性改变，需要临时治疗。结论重复SRS是一种安全有效的治疗残留davf的方法，可使症状改善和放射学完全消除。

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

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.