A Retrospective Analysis of the Outcomes of Dural Arteriovenous Fistulas Treated with Gamma Knife Radiosurgery: A Single-Institution Experience

作者：Seo Youngbeom; Kim Dong Gyu^*; Dho Yun Sik; Kim Jin Wook; Kim Yong Hwy; Park Chul Kee; Chung Hyun Tai; Paek Sun Ha

来源：Stereotactic and Functional Neurosurgery, 2018, 96(1): 46-53.

DOI：10.1159/000486685

• Arteriovenous fistula
• Dural arteriovenous fistula
• Stereotactic radiosurgery
• Gamma knife radiosurgery
• Outcome

Background: Gamma knife radiosurgery (GKRS) has recently been used as a treatment modality for dural arteriovenous fistula (DAVF). Objective: To retrospectively analyze the outcomes of GKRS for DAVF at a single institute. Methods: Between 1998 and 2016, a total of 20 patients underwent GKRS for DAVF. After excluding 4 patients with > 12 months of follow-up, 16 patients were enrolled in this study. Twelve patients had undergone embolization prior to GKRS. The most common location was the cavernous sinus (CS). The median clinical and radiological follow-up durations were 87.5 (range 24-186) months and 44.5 (range 14-174) months. Results: Ten (62.5%) of the 16 DAVFs were obliterated; 8 were confirmed on angiography. Five cases resulted in small, residual DAVFs, and one case remained unchanged. The obliteration rate of GKRS for CS DAVF was significantly higher than that for non-CS DAVF (100 vs. 40%; p = 0.034). Fifteen out of 16 patients (94%) had a favorable outcome, and the remaining patient had an unfavorable outcome. Hemorrhage after GKRS occurred in only 1 patient, who presented with seizure. Conclusions: GKRS is a safe and effective treatment modality for DAVF in combination with a traditional treatment option such as endovascular embolization or microsurgery.

• 出版日期2018