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022 ABO blood group analysis in cerebral dural arteriovenous fistulae
  1. E Murphy,
  2. J Pryor
  1. Neurointerventional Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA

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Introduction and Purpose: Thrombosis of dural arteriovenous fistulae (dAVF) is a well documented but rare phenomenon. Research suggests a connection between non-O blood grouping and thrombus formation in various organ systems; however, we report the first association of ABO blood type with spontaneous thrombosis in dAVF.

Material and Methods: Between February 2000 and July 2007, a total of 55 dAVFs were evaluated by our service for endovascular treatment. Data collected included patient age, sex, presenting symptoms, blood group and outcome.

Results: Blood type data were obtained for 46 patients. ABO blood group distribution was: 15 (32.6%) type O, 20 (43.5%) type A, nine (19.6%) type B and two (4.3%) with AB. Spontaneous thrombosis was noted in four of 46 (8.7%) identified dAVF cases, all with blood type A. Each of the four dAVF patients demonstrating spontaneous thrombosis received distinctive clinical management. One case underwent cerebral angiogram demonstrating complete spontaneous thrombosis following transfer from another institution. Embolization was attempted in one case but was unsuccessful due to anatomical challenges. Angiogram of the subsequent day showed complete thrombosis of the dAVF. Another case received coil embolization with residual dAVF on the final run and at 6 months. One year follow-up angiography demonstrated complete spontaneous thrombosis of the dAVF. The final case underwent glue embolization followed by surgical resection with persistent residual dAVF documented on post-operative and 1-month follow-up examination. Angiography at 6 weeks demonstrated spontaneous thrombosis of the residual dAVF and his dural sinuses. Of the 55 cases identified, 43 received embolization treatment. Angiographic obliteration of the dAVF was documented in 20 (46.5%) cases. ABO blood group analysis showed five patients (33%) were type O, seven (35%) type A, one (11%) type B and two (100%) type AB. Blood type data were unavailable in five cases.

Conclusion: Given the distribution of ABO blood type prevalence in the USA, ABO blood type A expression appears to be a strong predictor of spontaneous thrombosis in patients with dAVFs, in this series of patients approaching statistical significance.

Competing interests: JP, Micrus Endovascular, ev3.