Abstract 024: Endovascular Treatment of Cavernous Sinus Dural Arteriovenous Fistula: A Single Center experience

Abstract

Introduction The cavernous sinus dural arteriovenous fistula(CS‐DAVF) is a vascular condition that is a result of an unusual connection between the carotid artery branches and the cavernous sinus. This condition could be the result of trauma, infection, or other medical problems. In the case that conservative therapy fails or patients need emergency intervention, endovascular treatment (EVT) has been proposed as a main option for the treatment of these patients. In this study, we aimed to investigate the outcomes of the patients who underwent EVT for CS‐DAVF. Methods To gather information on patient demographics, symptoms, clinical and imaging characteristics, as well as the type of EVT and their outcomes after EVT, we recruited records of patients of our center from 2007. We used descriptive analyses to assess the characteristics of the included cases. Besides, inferential statistics were used to develop univariate and multivariate logistic regression models to identify factors linked to procedural success and symptom resolution at the follow‐up. Results Overall, 59 patients with a mean age of 64.37 years, a female‐to‐male ratio of 2.71, and a mean follow‐up time of 42.64 months were included. Chemosis, ptosis, and diplopia were the most frequent symptoms, and most of the patients were classified as Barrow classification type D based on angiographic features (30/58). In terms of EVT, most of the patients (54/59) underwent transvenous embolization, and liquids (Onyx 34 and 18) were the most frequent materials that were used for embolization (55/59). Also, in 34 cases, additional coiling was performed. Overall, the procedural success rate was 84% (50 out of 59), and a complete resolution of symptoms was observed in 46 cases at the follow‐up, with the occurrence of eight complications overall (13.5%), including two strokes, two alopecia, one seizure, one cranial nerve palsy, one diplopia and one worsening of symptom events. Multiple logistic regression showed that the use of Onyx 34 was associated with procedural success. Conclusion Our results showed that EVT might be a safe and effective option for the treatment of patients with CS‐DAVF. Also, the results showed that the application of Onyx 34 might associate with the procedural success rate.