Introduction Many studies demonstrated that endovascular embolization is an effective and safe technique for the occlusion of cranial dural arteriovenous fistulas (DAVFs). However, the quality of life (QoL) of the treated patients was not yet addressed before.
Aim of Study In this post-hoc analysis of the LIQUID study we aimed to systematically investigate the QoL of patients with high-grade DAVFs treated with endovascular embolization.
Methods The LIQUID study was a prospective multi-center study on the endovascular embolization of high-grade DAVF with the embolic agent Squid. EQ5D-3L was used for the assessment of the QoL. Patients were interviewed before and after treatment.
Results Pre-interventional EQ5D was available for 39 and post-interventional EQ5D for 46 patients. Patients with unruptured DAVFs mainly suffered from “pain and discomfort’ (50%) before treatment, while in case of ruptured DAVFs, complains were most frequently reported for “mobility’ and “usual activities’ (57.1%, respectively). After treatment, according to EQ5D, QoL improved in most patients across all items (e.g., EQ5D for “usual activities’: 2 or 3 in 55.9% before treatment vs. 23.5% after treatment). Deterioration of QoL was most frequently observed for “mobility’ which was reported to be worse in 26.5%. Non-improvement or worsening of the QoL was associated with treatment-related complications but not with the degree of occlusion after the treatment.
Conclusion After the embolization of high-grade DAVFs, the QoL of most of the treated patients improves substantially. However, especially in terms of mobility, non-improvement or worsening is regularly observed. The degree of occlusion does not influence the QoL.
Funding This is an investigator-initiated study. The Department of Neuroradiology, Heidelberg University Hospital received a scientific grant from Balt (Montmorency, France). The contributing centers received a case fee for each patient who was included in the study. Balt did not have an influence on the study design, data collection, analysis, and writing of the manuscript.
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