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Spontaneous angiographic conversion of intracranial dural arteriovenous shunt: long-term follow-up in nontreated patients

 Dong Joon Kim  ;  Karel terBrugge  ;  Timo Krings  ;  Robert Willinsky  ;  Christopher Wallace 
 STROKE, Vol.41(7) : 1489-1494, 2010 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Central Nervous System Vascular Malformations/diagnostic imaging* ; Central Nervous System Vascular Malformations/etiology ; Cerebral Angiography*/methods ; Child ; Child, Preschool ; Dura Mater/blood supply ; Dura Mater/diagnostic imaging* ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Time Factors ; Treatment Outcome ; Young Adult
BACKGROUND AND PURPOSE: Dural arteriovenous shunt (DAVS) is a disease in which abnormal arteriovenous communications develop within the dura. Some case series have suggested DAVS may evolve over time, but the natural history is poorly understood. In this study, we aimed to define the incidence and clinical characteristics of patients with DAVS showing spontaneous angiographic pattern conversion. METHODS: We assessed clinical and angiographic features of patients with angiographic conversion without any treatment from a single center database consisting of 335 DAVS cases. Spontaneous angiographic conversion was defined as complete occlusion of a pre-existing DAVS or conversion of a benign into an aggressive lesion on follow-up diagnostic subtraction angiography. RESULTS: One hundred twelve patients were followed without treatment after the initial diagnosis of DAVS. Overall, we saw pattern conversion on angiography in 18 of the 112 cases (16.1%). Fourteen patients showed spontaneous occlusion of the shunt (12.5%); the most common locations of spontaneous obliteration were the transverse and cavernous sinuses. Four patients showed conversion to an aggressive lesion from benign DAVS (4.0%); all of these cases were associated with occlusion of the ipsilateral draining vein. CONCLUSIONS: DAVS is a dynamic disorder, which will show chronological progression. Spontaneous angiographic obliteration or conversion into an aggressive type may occur on follow-up of untreated DAVSs.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
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