Treatment for intracranial dural arteriovenous malformations: a meta-analysis from the English language literature

Neurosurgery
C P LucasR Jacobowitz

Abstract

The treatment of intracranial dural arteriovenous malformations (DAVMs) remains problematic. Options include ligature of feeding vessels, endovascular procedures, surgical obliteration, or a combination of the latter two. We conducted a meta-analysis of the English language literature on DAVMs to determine the most effective treatment option related to location and angiographic characteristics. The criteria for inclusion were pre- and post-treatment angiography, a description of the type of treatment, and clinical outcome. The analysis included a total of 258 patients, 248 from a review of 223 published articles and 10 from the authors' series. DAVMs were divided into six categories by location, and the results of treatment were compared based on obliteration rates using chi 2 analysis. In transverse-sigmoid sinus DAVMs (n = 64), combined therapy (endovascular plus surgical treatment) proved significantly more effective than either therapy alone (P < 0.01). For lesions of the tentorial incisura (n = 66), combined therapy and surgical obliteration alone proved superior to embolization (P < 0.001). For lesions of the cavernous sinus (n = 67), treatment was primarily endovascular, with success rates of 62 to 78% for transarterial ...Continue Reading

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Citations

May 13, 2004·Journal of Neurosurgery·Goetz Benndorf, Thomas Nicolas Lehmann
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