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Efficacy and safety of stereotactic radiosurgery versus endovascular treatment for symptomatic cavernous sinus dural arteriovenous fistula without ophthalmological emergency: a single-center 10-year experience
DC Field | Value | Language |
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dc.contributor.author | 김동준 | - |
dc.contributor.author | 김병문 | - |
dc.contributor.author | 김용배 | - |
dc.contributor.author | 박근영 | - |
dc.contributor.author | 장원석 | - |
dc.contributor.author | 김민정 | - |
dc.contributor.author | 홍승우 | - |
dc.date.accessioned | 2024-01-03T01:12:38Z | - |
dc.date.available | 2024-01-03T01:12:38Z | - |
dc.date.issued | 2023-07 | - |
dc.identifier.issn | 0022-3085 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/197489 | - |
dc.description.abstract | Objective: Stereotactic radiosurgery (SRS) is emerging as a treatment option for cavernous sinus dural arteriovenous fistula (CS dAVF); it is less invasive and has a lower complication rate than conventional surgeries. However, little is known regarding the advantages and limitations of SRS compared to those of endovascular treatment (EVT). The aim of this study was to compare the efficacy and safety between EVT and SRS for treatment of CS dAVF. Methods: Between January 2011 and April 2021, a total of 86 consecutive patients diagnosed with CS dAVF were treated with EVT or SRS. Among them, 8 patients with ophthalmological emergency and 8 without follow-up data at ≥ 12 months were excluded. During the same period, no neurological deficit due to intracranial hemorrhage or seizure was noted in any of the patients. Ultimately, 70 patients (EVT 33, SRS 37) were included in this study. Demographic characteristics, initial clinical presentations, clinical outcomes, and radiological findings were retrospectively reviewed and compared. Procedure-related complications were also assessed after the treatments. Results: The patients' baseline characteristics (except conjunctival symptoms) and angiographic features of CS dAVF were not significantly different between the EVT and SRS groups. Conjunctival symptoms were more frequently noted in the EVT than in the SRS group (69.7% vs 40.5%, p = 0.015). After EVT, initial complete obliteration was achieved in 20 cases (60.6%). Complete obliteration was achieved at 6 months in 86.4% of cases with EVT and in 77.8% of those treated with SRS (p = 0.507), and at 12 months in 86.4% cases with EVT and in 94.4% of those treated with SRS (p = 0.357). Worsening of symptoms developed at 1 month in 24.2% of cases with EVT and in 5.4% of those treated with SRS (p = 0.038); at 6 months in 22.6% of cases with EVT and in 10.8% of those treated with SRS; and at 12 months in 30.0% of cases with EVT and in 13.5% of those treated with SRS (p = 0.099). The angioarchitecture of CS dAVF did not affect angiographic obliteration after SRS. Procedure-related morbidity and mortality occurred more frequently in the EVT than in the SRS group (27.3% vs 8.1%, p = 0.034). Conclusions: Both EVT and SRS were effective for the treatment of CS dAVF without ophthalmological emergency. However, procedure-related morbidity and mortality was less frequent in SRS than in EVT, and consequently SRS may be more advantageous in terms of safety. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | American Association of Neurological Surgeons | - |
dc.relation.isPartOf | JOURNAL OF NEUROSURGERY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Cavernous Sinus* / diagnostic imaging | - |
dc.subject.MESH | Cavernous Sinus* / surgery | - |
dc.subject.MESH | Central Nervous System Vascular Malformations* / complications | - |
dc.subject.MESH | Central Nervous System Vascular Malformations* / diagnostic imaging | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Radiosurgery* / adverse effects | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Treatment Outcome | - |
dc.title | Efficacy and safety of stereotactic radiosurgery versus endovascular treatment for symptomatic cavernous sinus dural arteriovenous fistula without ophthalmological emergency: a single-center 10-year experience | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Radiology (영상의학교실) | - |
dc.contributor.googleauthor | Min Jeoung Kim | - |
dc.contributor.googleauthor | Seung Woo Hong | - |
dc.contributor.googleauthor | Dong Joon Kim | - |
dc.contributor.googleauthor | Byung Moon Kim | - |
dc.contributor.googleauthor | Yong Bae Kim | - |
dc.contributor.googleauthor | Won Seok Chang | - |
dc.contributor.googleauthor | Keun Young Park | - |
dc.identifier.doi | 10.3171/2022.10.JNS221770 | - |
dc.contributor.localId | A00410 | - |
dc.contributor.localId | A00498 | - |
dc.contributor.localId | A00743 | - |
dc.contributor.localId | A01442 | - |
dc.contributor.localId | A03454 | - |
dc.relation.journalcode | J01636 | - |
dc.identifier.eissn | 1933-0693 | - |
dc.identifier.pmid | 36461825 | - |
dc.identifier.url | https://thejns.org/view/journals/j-neurosurg/139/1/article-p139.xml | - |
dc.subject.keyword | cavernous sinus | - |
dc.subject.keyword | dural arteriovenous fistula | - |
dc.subject.keyword | endovascular neurosurgery | - |
dc.subject.keyword | endovascular treatment | - |
dc.subject.keyword | radiosurgery | - |
dc.subject.keyword | stereotactic radiosurgery | - |
dc.subject.keyword | vascular disorders | - |
dc.contributor.alternativeName | Kim, Dong Joon | - |
dc.contributor.affiliatedAuthor | 김동준 | - |
dc.contributor.affiliatedAuthor | 김병문 | - |
dc.contributor.affiliatedAuthor | 김용배 | - |
dc.contributor.affiliatedAuthor | 박근영 | - |
dc.contributor.affiliatedAuthor | 장원석 | - |
dc.citation.volume | 139 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 139 | - |
dc.citation.endPage | 149 | - |
dc.identifier.bibliographicCitation | JOURNAL OF NEUROSURGERY, Vol.139(1) : 139-149, 2023-07 | - |
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