Thoracolumbar spinal dural arteriovenous fistulae present with longer arteriovenous transit compared to cranial and cervical dural fistulae.

IF 1.7 4区 医学 Q3 Medicine Interventional Neuroradiology Pub Date : 2025-02-01 Epub Date: 2023-01-05 DOI:10.1177/15910199221149096
Ze'ev Itsekzon-Hayosh, Eef J Hendriks, Sean T O'Reilly, Rabab Al Shahrani, Ronit Agid, Patrick Nicholson, Karel Terbrugge, Ivan Radovanovic, Hugo Andrade, Joanna D Schaafsma, Timo Krings
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Abstract

Background: Thoraco-lumbar spinal dural arteriovenous fistulae represent a rare subset of central nervous system vascular malformations. One of the unique features of spinal dural arteriovenous fistulae is their extremely low propensity to cause hemorrhage (either parenchymal or subarachnoid), with a distinct clinical presentation of myelopathy secondary to spinal venous congestion. The exact mechanism for this unique presentation is still unclear.

Methods: Following institutional review board approval, we retrospectively analyzed our prospectively maintained database of spinal dural arteriovenous fistulae and cranial (cr) DAVF cases presenting between 2008 and 2021. For all cases, angiograms were reviewed and arteriovenous transit times were calculated. Patient demographics, angiographic features, and clinical and radiological outcomes were assessed.

Results: In total, 66 patients presenting with confirmed thoracolumbar spinal dural arteriovenous fistulaes were identified and compared to patients presenting with cervical spinal dural arteriovenous fistulaes (n  =  10), ruptured crDAVFs (n  =  32) and unruptured crDAVFs (n  =  20). Mean age in the target group was 66  ±  13 versus 57-62 in the other groups, p < 0.05 on one-way analysis of variance; with 80% males versus 50%-65% in other groups. Mean arteriovenous transit time in the thoracolumbar group measured 1.98 s ± 0.96 versus 0.25-0.5 s range in other groups (p < 0.0001 on one-way analysis of variance).

Conclusion: Prolonged arteriovenous transit times may represent a distinct feature of thoracolumbar spinal dural arteriovenous fistulaes. This may, amongst other factors, play a role in the observed lesser likelihood of hemorrhagic complications compared to other dural arteriovenous shunts.

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与头颅和颈椎硬膜瘘相比,胸腰椎硬膜动静脉瘘的动静脉通过时间更长。
背景:胸腰椎硬脊膜动静脉瘘是中枢神经系统血管畸形的一个罕见亚型。脊髓硬膜动静脉瘘的独特之处之一是极易引起出血(实质出血或蛛网膜下腔出血),其独特的临床表现是脊髓静脉充血继发脊髓病变。这种独特表现的确切机制尚不清楚:在获得机构审查委员会批准后,我们回顾性分析了前瞻性维护的数据库中 2008 年至 2021 年间出现的脊髓硬膜动静脉瘘和头颅(cr)DAVF 病例。我们对所有病例的血管造影进行了审查,并计算了动静脉通过时间。对患者的人口统计学特征、血管造影特征以及临床和放射学结果进行了评估:共确定了 66 例确诊胸腰椎硬脊膜动静脉瘘患者,并与颈椎硬脊膜动静脉瘘(10 例)、破裂的 crDAVF(32 例)和未破裂的 crDAVF(20 例)患者进行了比较。目标组的平均年龄为 66±13 岁,而其他组为 57-62 岁,p p 结论:动静脉过境时间延长可能是胸腰椎硬膜动静脉瘘的一个明显特征。与其他硬膜动静脉分流术相比,这可能是出血并发症发生率较低的原因之一。
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来源期刊
CiteScore
2.80
自引率
11.80%
发文量
192
审稿时长
6-12 weeks
期刊介绍: Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...
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