Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive Impairment
Introduction Dural arteriovenous fistulas (dAVFs) have been associated with rapidly progressive dementia in relatively young patients. However, the specific angioarchitecture and characteristics of these dAVFs remain to be fully described. To better understand the specific characteristics of dAVFs a...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-11-01
|
| Series: | Stroke: Vascular and Interventional Neurology |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.082 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850268342840983552 |
|---|---|
| author | Sebastian A. Sanchez Linder Wendt Chen Ching‐Jen Minako Hayakawa Edgar Samaniego Jason Sheehan Louis Kim Issac Abecassis Michael Levitt Michael Meyer Ridhima Guniganti Akash Pabaney Giuseppe Lanzino Enrico Giordan Waleed Brinjikji Diederik Bulters Santiago Ortega Andrew Durnford Gregory Zipfel W Fox Colin Derdeyn Jessica Smith Bradley Gross Sepideh Amin‐Hanjani Ali Alaraj |
| author_facet | Sebastian A. Sanchez Linder Wendt Chen Ching‐Jen Minako Hayakawa Edgar Samaniego Jason Sheehan Louis Kim Issac Abecassis Michael Levitt Michael Meyer Ridhima Guniganti Akash Pabaney Giuseppe Lanzino Enrico Giordan Waleed Brinjikji Diederik Bulters Santiago Ortega Andrew Durnford Gregory Zipfel W Fox Colin Derdeyn Jessica Smith Bradley Gross Sepideh Amin‐Hanjani Ali Alaraj |
| author_sort | Sebastian A. Sanchez |
| collection | DOAJ |
| description | Introduction Dural arteriovenous fistulas (dAVFs) have been associated with rapidly progressive dementia in relatively young patients. However, the specific angioarchitecture and characteristics of these dAVFs remain to be fully described. To better understand the specific characteristics of dAVFs associated with cognitive impairment (dAVF‐CI), we utilized the CONDOR multicenter database, which provides a large cohort of dAVF available. By analyzing data from patients with dAVFs‐ CI, we aimed to identify the key features distinguishing these cases and elaborate on the pathophysiology of dAVF‐CI. Methods CONDOR is an international multicenter database comprising 1077 (dAVFs) from 14 international centers. We conducted a retrospective analysis of the CONDOR database, focusing on patients diagnosed with dAVFs‐CI. Propensity score matching analysis was performed to compare Borden type II and type III dAVFs with and without cognitive impairment as control groups. Only dAVFs with cortical venous drainage were included as this aggressive subtype can present with non‐hemorrhagic neurologic deficits. Additionally, logistic regression was then employed to identify significant characteristics associated with dAVF‐CI. Results A total of 60 patients with dAVF‐CI and 60 control dAVFs were included in the analysis. The patients with dAVF‐CI had a mean age of 58 ± 18 years. It was found that all cases of dAVF‐CI exhibited venous hypertension. Additionally, there was a significant association between sinus stenosis and dAVF‐CI (OR: 2.85, 95% CI: 1.16‐7.55, p = 0.027). Moreover, dAVF‐CI cases were characterized by the presence of multiple arteriovenous shunts, with more arterial feeders (OR 1.56, 95% CI 1.22‐2.05, p <0.001) and draining veins (OR 2.05, 95% CI 1.05‐4.46, p = 0.004) compared to the control dAVFs. Venous ectasia was also found to be associated with dAVF‐CI (OR 2.38, 95% CI 1.13‐5.11, p= 0.024). Finally, some patients in which successful dAVF closure was achieved had symptom resolution during follow‐up (OR 2.86, 95% CI 0.85‐9.56, p = 0.09). Conclusion dAVFs‐CI tend to occur in relatively young patients and are characterized by the presence of venous hypertension. The development of sinus stenosis and venous ectasia further hinders proper drainage, contributing to the persistence of venous hypertension. Venous hypertension may impair critical structures such as the thalamus or the cortex leading to rapid cognitive impairment. Successful treatment of dAVFs‐CI can potentially reverse symptoms. Nonetheless, some dAVF‐CI may have persistent symptoms due to chronic hypertension and infarction. |
| format | Article |
| id | doaj-art-b85b0096dd9046dc8aef858c73373578 |
| institution | OA Journals |
| issn | 2694-5746 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj-art-b85b0096dd9046dc8aef858c733735782025-08-20T01:53:30ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-11-013S210.1161/SVIN.03.suppl_2.082Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive ImpairmentSebastian A. Sanchez0Linder Wendt1Chen Ching‐Jen2Minako Hayakawa3Edgar Samaniego4Jason Sheehan5Louis Kim6Issac Abecassis7Michael Levitt8Michael Meyer9Ridhima Guniganti10Akash Pabaney11Giuseppe Lanzino12Enrico Giordan13Waleed Brinjikji14Diederik Bulters15Santiago Ortega16Andrew Durnford17Gregory Zipfel18W Fox19Colin Derdeyn20Jessica Smith21Bradley Gross22Sepideh Amin‐Hanjani23Ali Alaraj24University of Iowa Hospitals and Clinics Iowa United StatesInstitute for Clinical and Translational Science University of Iowa Hospitals and Clinics Iowa United StatesDepartment of Neurosurgery The University of Texas Health Science Center at Houston Texas United StatesDepartment of Radiology The University of Iowa Hospitals and Clinics Iowa United StatesThe University of Iowa Hospital and Clinics Iowa United StatesDepartment of Neurosurgery University of Virginia Health System Virginia United StatesDepartment of Neurosurgery University of Washington Washington United StatesDepartment of Neurosurgery University of Washington Washington United StatesDepartment of Neurosurgery University of Washington Washington United StatesDepartment of Neurosurgery University of Washington Washington United StatesDepartment of Neurosurgery Washington University School of Medicine in Saint Louis Misuri United StatesMallinckrodt Institute of Radiology Washington University School of Medicine in Saint Louis Misuri United StatesDepartment of Neurosurgery Mayo Clinic Minesota United StatesDepartment of Neurosurgery Mayo Clinic Minesota United StatesDepartment of Radiology Mayo Clinic Minesota United StatesDepartment of Neurosurgery University Hospital Southampton Hampshire United KingdomDepartment of Neurology The University of Iowa Hospitals and Clinics Iowa United StatesDepartment of Neurosurgery University Hospital Southampton Hampshire United KingdomDepartment of Neurosurgery University of Virginia Health System Virginia United States13. Department of Neurosurgery Mayo Clinic Jacksonville Campus Florida United StatesInstitute for Clinical and Translational Science University of Iowa Hospitals and Clinics Iowa United StatesDepartment of Neurosurgery University of Florida Florida United StatesDepartment of Neurosurgery University of Pittsburgh Medical Center Health System Pensilvania United StatesDepartment of Neurosurgery University of Miami Florida United StatesDepartment of Neurosurgery University of Illinois Chicago Illinois United StatesIntroduction Dural arteriovenous fistulas (dAVFs) have been associated with rapidly progressive dementia in relatively young patients. However, the specific angioarchitecture and characteristics of these dAVFs remain to be fully described. To better understand the specific characteristics of dAVFs associated with cognitive impairment (dAVF‐CI), we utilized the CONDOR multicenter database, which provides a large cohort of dAVF available. By analyzing data from patients with dAVFs‐ CI, we aimed to identify the key features distinguishing these cases and elaborate on the pathophysiology of dAVF‐CI. Methods CONDOR is an international multicenter database comprising 1077 (dAVFs) from 14 international centers. We conducted a retrospective analysis of the CONDOR database, focusing on patients diagnosed with dAVFs‐CI. Propensity score matching analysis was performed to compare Borden type II and type III dAVFs with and without cognitive impairment as control groups. Only dAVFs with cortical venous drainage were included as this aggressive subtype can present with non‐hemorrhagic neurologic deficits. Additionally, logistic regression was then employed to identify significant characteristics associated with dAVF‐CI. Results A total of 60 patients with dAVF‐CI and 60 control dAVFs were included in the analysis. The patients with dAVF‐CI had a mean age of 58 ± 18 years. It was found that all cases of dAVF‐CI exhibited venous hypertension. Additionally, there was a significant association between sinus stenosis and dAVF‐CI (OR: 2.85, 95% CI: 1.16‐7.55, p = 0.027). Moreover, dAVF‐CI cases were characterized by the presence of multiple arteriovenous shunts, with more arterial feeders (OR 1.56, 95% CI 1.22‐2.05, p <0.001) and draining veins (OR 2.05, 95% CI 1.05‐4.46, p = 0.004) compared to the control dAVFs. Venous ectasia was also found to be associated with dAVF‐CI (OR 2.38, 95% CI 1.13‐5.11, p= 0.024). Finally, some patients in which successful dAVF closure was achieved had symptom resolution during follow‐up (OR 2.86, 95% CI 0.85‐9.56, p = 0.09). Conclusion dAVFs‐CI tend to occur in relatively young patients and are characterized by the presence of venous hypertension. The development of sinus stenosis and venous ectasia further hinders proper drainage, contributing to the persistence of venous hypertension. Venous hypertension may impair critical structures such as the thalamus or the cortex leading to rapid cognitive impairment. Successful treatment of dAVFs‐CI can potentially reverse symptoms. Nonetheless, some dAVF‐CI may have persistent symptoms due to chronic hypertension and infarction.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.082 |
| spellingShingle | Sebastian A. Sanchez Linder Wendt Chen Ching‐Jen Minako Hayakawa Edgar Samaniego Jason Sheehan Louis Kim Issac Abecassis Michael Levitt Michael Meyer Ridhima Guniganti Akash Pabaney Giuseppe Lanzino Enrico Giordan Waleed Brinjikji Diederik Bulters Santiago Ortega Andrew Durnford Gregory Zipfel W Fox Colin Derdeyn Jessica Smith Bradley Gross Sepideh Amin‐Hanjani Ali Alaraj Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive Impairment Stroke: Vascular and Interventional Neurology |
| title | Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive Impairment |
| title_full | Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive Impairment |
| title_fullStr | Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive Impairment |
| title_full_unstemmed | Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive Impairment |
| title_short | Abstract 082: Angiographic Features and Treatment Results of Dural Arteriovenous Fistulas Cognitive Impairment |
| title_sort | abstract 082 angiographic features and treatment results of dural arteriovenous fistulas cognitive impairment |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.082 |
| work_keys_str_mv | AT sebastianasanchez abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT linderwendt abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT chenchingjen abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT minakohayakawa abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT edgarsamaniego abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT jasonsheehan abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT louiskim abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT issacabecassis abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT michaellevitt abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT michaelmeyer abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT ridhimaguniganti abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT akashpabaney abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT giuseppelanzino abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT enricogiordan abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT waleedbrinjikji abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT diederikbulters abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT santiagoortega abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT andrewdurnford abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT gregoryzipfel abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT wfox abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT colinderdeyn abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT jessicasmith abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT bradleygross abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT sepidehaminhanjani abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment AT alialaraj abstract082angiographicfeaturesandtreatmentresultsofduralarteriovenousfistulascognitiveimpairment |