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Abstract
Objectives With recent advancements in minimally invasive techniques, endovascular embolization has gained popularity as a first line treatment option for spinal dural arteriovenous fistulas (sDAVFs).We present our institution’s case series of sDAVFs treated endovascularly and surgically and performed a systemic review to assess the outcomes of both modalities of treatment.
Methods We conduct a retrospective observational study of 24 consecutive patients with sDAVFs treated between 2013 and 2023. The primary outcome was the rate of occlusion this was compared between the surgically and endovascularly treated sDAVFs. Results: A total of 24 patients with 24 sDAVFs were studied with a mean age of 63.8 years ± 15.5 and the majority were males (n= 19,79.2%). Of the 24, 8 (33.3%) patients received endovascular treatment, 15 (62.5%) received surgical treatment, and 1 (4.2%) patient received both. Complete occlusion at first follow-up was higher in the surgical cohort but did not achieve statistical significance (66.7% vs 25%, p=0.52). Recurrence was higher in the endovascular cohort (37.5% vs 13.3%, p= 0.3) while the rate of post-procedural complications was higher in the surgical cohort (13.3% vs 0%, p=0.52), however neither of them were statistically significant.
Conclusion Endovascular embolization in the management of sDAVFs is an alternative treatment to surgery, whose long-term efficacy is still under investigation. Our study findings suggest overall comparable outcomes between endovascular and open surgical treatment of sDAVFs. Future studies are needed to determine the role of endovascular embolization in the overall management of sDAVFs.
Subgroup analysis of outcomes between surgical and endovascular treatment of sDAVFs.LOS=length of stay,F/U=follow-up
Disclosures K. El Naamani: None. A. Kaul: None. N. Mouchtouris: None. A. Hunt: None. M. Ahmed: None. S. Sizdahkhani: None. S. Majmundar: None. M. Ghanem: None. N. Herial: None. P. Jabbour: 2; C; Medtronic, MicroVention, Balt, Cerus Endovascular. R. Rosenwasser: None. S. Tjoumakaris: 2; C; MicroVention.