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<meta name="DC.Title" content="Intraoperative Angiography for Cranial Dural Arteriovenous Fistula" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2443" />
<meta name="DC.Date" content="2011-06-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: IA is a valuable adjunct during surgery for a variety of neurovascular diseases; however, there are no reported series describing IA for DAVFs. This study was undertaken to evaluate the safety and efficacy of IA for DAVFs.

MATERIALS AND METHODS: A retrospective review of DAVF surgical cases during a 20-year period was conducted, and cases with IA were evaluated. Clinical details, surgical and angiographic findings, and postoperative outcomes were reviewed. The incidence of residual fistula on IAs, the utility of the surgical procedure, and the incidence of false-negative findings on IA were also determined.

RESULTS: IA was performed in 29 patients (31 DAVFs) for DAVFs. The distribution of the fistulas was the following: transverse-sigmoid ( n = 9), tentorial ( n = 6), torcular ( n = 3), cavernous sinus ( n = 4), SSS ( n = 4), foramen magnum ( n = 3), and temporal-middle fossa ( n = 2). Twelve patients had undergone prior embolization, while 6 patients had unsuccessful embolization procedures. Thirty-eight surgeries were performed for DAVF in 29 patients, and IA was performed in 34 surgeries. Forty-four angiographic procedures were performed in the 34 surgeries. Nine patients underwent multiple angiographies. In 11 patients (37.9%), IA revealed residual fistula after the surgeon determined that no lesion remained. This led to further exploration at the same sitting in 10 patients, while in 1 patient, further surgery was performed at a later date. False-negative findings on IA occurred in 3 patients (10.7%).

CONCLUSIONS: IA is an important adjunct in surgery for DAVF. In this series, it resulted in further surgical treatment in 37.9% of patients. However, there was a 10% false-negative rate, which justified subsequent postoperative angiography.

AVM
:   arteriovenous malformation
CCF
:   carotid cavernous fistula
DAVF
:   dural arteriovenous fistula
ECA
:   external carotid artery
IA
:   intraoperative angiography
ICA
:   internal carotid artery
LECA
:   left external carotid artery
LVA
:   left vertebral artery
NPV
:   negative predictive value
PPV
:   positive predictive value
SSS
:   superior sagittal sinus" />
<meta name="DC.Contributor" content="P. Pandey" />
<meta name="DC.Contributor" content="G.K. Steinberg" />
<meta name="DC.Contributor" content="E.M. Westbroek" />
<meta name="DC.Contributor" content="R. Dodd" />
<meta name="DC.Contributor" content="H.M. Do" />
<meta name="DC.Contributor" content="M.P. Marks" />
<meta name="article:published_time" content="2011-06-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Intraoperative Angiography for Cranial Dural Arteriovenous Fistula" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;IA is a valuable adjunct during surgery for a variety of neurovascular diseases; however, there are no reported series describing IA for  DAVFs. This study was undertaken to evaluate the safety and efficacy of IA for DAVFs.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A retrospective review of DAVF surgical cases during a 20-year period was conducted, and cases with IA were evaluated. Clinical details, surgical and angiographic findings, and postoperative outcomes were reviewed. The incidence of residual fistula on IAs, the utility of the surgical procedure, and the incidence of false-negative findings on IA were also  determined.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;IA was performed in 29 patients (31 DAVFs) for DAVFs. The distribution of the fistulas was the following: transverse-sigmoid (&lt;i&gt;n&lt;/i&gt; = 9), tentorial (&lt;i&gt;n&lt;/i&gt; = 6), torcular (&lt;i&gt;n&lt;/i&gt; = 3), cavernous sinus (&lt;i&gt;n&lt;/i&gt; = 4), SSS (&lt;i&gt;n&lt;/i&gt; = 4), foramen magnum (&lt;i&gt;n&lt;/i&gt; = 3), and temporal-middle fossa (&lt;i&gt;n&lt;/i&gt; = 2). Twelve patients had undergone prior embolization, while 6 patients had unsuccessful embolization procedures. Thirty-eight surgeries were performed for DAVF in 29 patients, and IA was performed in 34 surgeries. Forty-four angiographic procedures were performed in the 34 surgeries. Nine patients underwent multiple angiographies. In 11 patients (37.9%), IA revealed residual fistula after the surgeon determined that no lesion remained. This led to further exploration at the same sitting in 10 patients, while in 1 patient, further surgery was performed at a later date. False-negative findings on IA occurred in 3 patients  (10.7%).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;IA is an important adjunct in surgery for DAVF. In this series, it resulted in further surgical treatment in 37.9% of patients. However, there was a 10% false-negative rate, which justified subsequent postoperative  angiography.&lt;/p&gt;" />
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<meta name="twitter:title" content="Intraoperative Angiography for Cranial Dural Arteriovenous Fistula" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: IA is a valuable adjunct during surgery for a variety of neurovascular diseases; however, there are no reported series describing IA for DAVFs. This study was undertaken to evaluate the safety and efficacy of IA for DAVFs.

MATERIALS AND METHODS: A retrospective review of DAVF surgical cases during a 20-year period was conducted, and cases with IA were evaluated. Clinical details, surgical and angiographic findings, and postoperative outcomes were reviewed. The incidence of residual fistula on IAs, the utility of the surgical procedure, and the incidence of false-negative findings on IA were also determined.

RESULTS: IA was performed in 29 patients (31 DAVFs) for DAVFs. The distribution of the fistulas was the following: transverse-sigmoid ( n = 9), tentorial ( n = 6), torcular ( n = 3), cavernous sinus ( n = 4), SSS ( n = 4), foramen magnum ( n = 3), and temporal-middle fossa ( n = 2). Twelve patients had undergone prior embolization, while 6 patients had unsuccessful embolization procedures. Thirty-eight surgeries were performed for DAVF in 29 patients, and IA was performed in 34 surgeries. Forty-four angiographic procedures were performed in the 34 surgeries. Nine patients underwent multiple angiographies. In 11 patients (37.9%), IA revealed residual fistula after the surgeon determined that no lesion remained. This led to further exploration at the same sitting in 10 patients, while in 1 patient, further surgery was performed at a later date. False-negative findings on IA occurred in 3 patients (10.7%).

CONCLUSIONS: IA is an important adjunct in surgery for DAVF. In this series, it resulted in further surgical treatment in 37.9% of patients. However, there was a 10% false-negative rate, which justified subsequent postoperative angiography.

AVM
:   arteriovenous malformation
CCF
:   carotid cavernous fistula
DAVF
:   dural arteriovenous fistula
ECA
:   external carotid artery
IA
:   intraoperative angiography
ICA
:   internal carotid artery
LECA
:   left external carotid artery
LVA
:   left vertebral artery
NPV
:   negative predictive value
PPV
:   positive predictive value
SSS
:   superior sagittal sinus" />
<meta name="og-title" property="og:title" content="Intraoperative Angiography for Cranial Dural Arteriovenous Fistula" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/32/6/1091" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: IA is a valuable adjunct during surgery for a variety of neurovascular diseases; however, there are no reported series describing IA for DAVFs. This study was undertaken to evaluate the safety and efficacy of IA for DAVFs.

MATERIALS AND METHODS: A retrospective review of DAVF surgical cases during a 20-year period was conducted, and cases with IA were evaluated. Clinical details, surgical and angiographic findings, and postoperative outcomes were reviewed. The incidence of residual fistula on IAs, the utility of the surgical procedure, and the incidence of false-negative findings on IA were also determined.

RESULTS: IA was performed in 29 patients (31 DAVFs) for DAVFs. The distribution of the fistulas was the following: transverse-sigmoid ( n = 9), tentorial ( n = 6), torcular ( n = 3), cavernous sinus ( n = 4), SSS ( n = 4), foramen magnum ( n = 3), and temporal-middle fossa ( n = 2). Twelve patients had undergone prior embolization, while 6 patients had unsuccessful embolization procedures. Thirty-eight surgeries were performed for DAVF in 29 patients, and IA was performed in 34 surgeries. Forty-four angiographic procedures were performed in the 34 surgeries. Nine patients underwent multiple angiographies. In 11 patients (37.9%), IA revealed residual fistula after the surgeon determined that no lesion remained. This led to further exploration at the same sitting in 10 patients, while in 1 patient, further surgery was performed at a later date. False-negative findings on IA occurred in 3 patients (10.7%).

CONCLUSIONS: IA is an important adjunct in surgery for DAVF. In this series, it resulted in further surgical treatment in 37.9% of patients. However, there was a 10% false-negative rate, which justified subsequent postoperative angiography.

AVM
:   arteriovenous malformation
CCF
:   carotid cavernous fistula
DAVF
:   dural arteriovenous fistula
ECA
:   external carotid artery
IA
:   intraoperative angiography
ICA
:   internal carotid artery
LECA
:   left external carotid artery
LVA
:   left vertebral artery
NPV
:   negative predictive value
PPV
:   positive predictive value
SSS
:   superior sagittal sinus" />
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      <h1 class="highwire-cite-title" id="page-title">Intraoperative Angiography for Cranial Dural Arteriovenous Fistula</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P. Pandey</span>, <span class="highwire-citation-author" data-delta="1">G.K. Steinberg</span>, <span class="highwire-citation-author" data-delta="2">E.M. Westbroek</span>, <span class="highwire-citation-author" data-delta="3">R. Dodd</span>, <span class="highwire-citation-author" data-delta="4">H.M. Do</span> and <span class="highwire-citation-author" data-delta="5">M.P. Marks</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2011,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1091-1095; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2443 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9502--6639125652" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">P. Pandey </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BPandey%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pandey%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2BPandey%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">G.K. 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<p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> IA is a valuable adjunct during surgery for a variety of neurovascular diseases; however, there are no reported series describing IA for  DAVFs. This study was undertaken to evaluate the safety and efficacy of IA for DAVFs.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS:</strong> A retrospective review of DAVF surgical cases during a 20-year period was conducted, and cases with IA were evaluated. Clinical details, surgical and angiographic findings, and postoperative outcomes were reviewed. The incidence of residual fistula on IAs, the utility of the surgical procedure, and the incidence of false-negative findings on IA were also  determined.</p>
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<p id="p-3"><strong>RESULTS:</strong> IA was performed in 29 patients (31 DAVFs) for DAVFs. The distribution of the fistulas was the following: transverse-sigmoid (<em>n</em> = 9), tentorial (<em>n</em> = 6), torcular (<em>n</em> = 3), cavernous sinus (<em>n</em> = 4), SSS (<em>n</em> = 4), foramen magnum (<em>n</em> = 3), and temporal-middle fossa (<em>n</em> = 2). Twelve patients had undergone prior embolization, while 6 patients had unsuccessful embolization procedures. Thirty-eight surgeries were performed for DAVF in 29 patients, and IA was performed in 34 surgeries. Forty-four angiographic procedures were performed in the 34 surgeries. Nine patients underwent multiple angiographies. In 11 patients (37.9%), IA revealed residual fistula after the surgeon determined that no lesion remained. This led to further exploration at the same sitting in 10 patients, while in 1 patient, further surgery was performed at a later date. False-negative findings on IA occurred in 3 patients  (10.7%).</p>
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<p id="p-4"><strong>CONCLUSIONS:</strong> IA is an important adjunct in surgery for DAVF. In this series, it resulted in further surgical treatment in 37.9% of patients. However, there was a 10% false-negative rate, which justified subsequent postoperative  angiography.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">AVM<span class="def-item-dt-sep"></span></dt><dd>arteriovenous malformation<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">CCF<span class="def-item-dt-sep"></span></dt><dd>carotid cavernous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">DAVF<span class="def-item-dt-sep"></span></dt><dd>dural arteriovenous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">ECA<span class="def-item-dt-sep"></span></dt><dd>external carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">IA<span class="def-item-dt-sep"></span></dt><dd>intraoperative angiography<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">ICA<span class="def-item-dt-sep"></span></dt><dd>internal carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">LECA<span class="def-item-dt-sep"></span></dt><dd>left external carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">LVA<span class="def-item-dt-sep"></span></dt><dd>left vertebral artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">NPV<span class="def-item-dt-sep"></span></dt><dd>negative predictive value<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">PPV<span class="def-item-dt-sep"></span></dt><dd>positive predictive value<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">SSS<span class="def-item-dt-sep"></span></dt><dd>superior sagittal  sinus</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/32/6/1091.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Intraoperative Angiography for Cranial Dural Arteriovenous Fistula</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jun 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1091-1095; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2443 </span></div>
  
  
  
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