Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders
ObjectiveArteriovenous fistulas (AVFs) in the craniocervical junction (CCJ) region are a rare occurrence with special clinical manifestations. This study retrospectively reviewed patients with CCJ AVFs treated at our neurosurgical center, aiming to enhance the understanding of CCJ AVFs.MethodsA tota...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-01-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1076549/full |
| _version_ | 1797959995466186752 |
|---|---|
| author | Zihao Song Zihao Song Yongjie Ma Yongjie Ma Yinqing Wang Yinqing Wang Chuan He Chuan He Guilin Li Guilin Li Peng Zhang Peng Zhang Tao Hong Tao Hong Liyong Sun Liyong Sun Peng Hu Peng Hu Ming Ye Ming Ye Hongqi Zhang Hongqi Zhang |
| author_facet | Zihao Song Zihao Song Yongjie Ma Yongjie Ma Yinqing Wang Yinqing Wang Chuan He Chuan He Guilin Li Guilin Li Peng Zhang Peng Zhang Tao Hong Tao Hong Liyong Sun Liyong Sun Peng Hu Peng Hu Ming Ye Ming Ye Hongqi Zhang Hongqi Zhang |
| author_sort | Zihao Song |
| collection | DOAJ |
| description | ObjectiveArteriovenous fistulas (AVFs) in the craniocervical junction (CCJ) region are a rare occurrence with special clinical manifestations. This study retrospectively reviewed patients with CCJ AVFs treated at our neurosurgical center, aiming to enhance the understanding of CCJ AVFs.MethodsA total of 113 patients with CCJ AVFs treated at our neurosurgical center between January 2013 and December 2020 were enrolled. They were grouped as patients with CCJ AVFs with spinal arterial feeders (n = 20) and patients with CCJ AVF without spinal arterial feeders (n = 93). Clinical presentation, angiographic characteristics, intraoperative findings, and treatment outcomes were analyzed.ResultsThe patients’ median age was 55 years (IQR 47.5–62 years). The proportion of males in the group without spinal arterial feeders was significantly higher (p = 0.001). Subarachnoid hemorrhage (SAH) was the most common clinical presentation, especially in the group with spinal arterial feeders (p < 0.001). There were significant differences in AVF type, fistula location, and direction of the venous drainage between the two groups (p < 0.001). Intervention embolization combined with microsurgery was more common in treating AVFs with spinal arterial feeders (p = 0.006). Spinal arterial feeders did not affect the outcome (p = 0.275).ConclusionsSAH was the most common presentation of CCJ AVFs in this study. Microsurgery and interventional embolization were optional treatment strategies. The angioarchitecture of CCJ AVFs was essential for selecting treatment strategies. |
| first_indexed | 2024-04-11T00:39:41Z |
| format | Article |
| id | doaj.art-df221ac443dc4870ac4ad16367b97567 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T00:39:41Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-df221ac443dc4870ac4ad16367b975672023-01-06T11:06:23ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.10765491076549Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feedersZihao Song0Zihao Song1Yongjie Ma2Yongjie Ma3Yinqing Wang4Yinqing Wang5Chuan He6Chuan He7Guilin Li8Guilin Li9Peng Zhang10Peng Zhang11Tao Hong12Tao Hong13Liyong Sun14Liyong Sun15Peng Hu16Peng Hu17Ming Ye18Ming Ye19Hongqi Zhang20Hongqi Zhang21Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaChina International Neuroscience Institute (China-INI), Beijing, ChinaObjectiveArteriovenous fistulas (AVFs) in the craniocervical junction (CCJ) region are a rare occurrence with special clinical manifestations. This study retrospectively reviewed patients with CCJ AVFs treated at our neurosurgical center, aiming to enhance the understanding of CCJ AVFs.MethodsA total of 113 patients with CCJ AVFs treated at our neurosurgical center between January 2013 and December 2020 were enrolled. They were grouped as patients with CCJ AVFs with spinal arterial feeders (n = 20) and patients with CCJ AVF without spinal arterial feeders (n = 93). Clinical presentation, angiographic characteristics, intraoperative findings, and treatment outcomes were analyzed.ResultsThe patients’ median age was 55 years (IQR 47.5–62 years). The proportion of males in the group without spinal arterial feeders was significantly higher (p = 0.001). Subarachnoid hemorrhage (SAH) was the most common clinical presentation, especially in the group with spinal arterial feeders (p < 0.001). There were significant differences in AVF type, fistula location, and direction of the venous drainage between the two groups (p < 0.001). Intervention embolization combined with microsurgery was more common in treating AVFs with spinal arterial feeders (p = 0.006). Spinal arterial feeders did not affect the outcome (p = 0.275).ConclusionsSAH was the most common presentation of CCJ AVFs in this study. Microsurgery and interventional embolization were optional treatment strategies. The angioarchitecture of CCJ AVFs was essential for selecting treatment strategies.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1076549/fullarteriovenous fistulaarteriovenous shuntcraniocervical junctionspinal vascular malformationsubarachnoid hemorrhage |
| spellingShingle | Zihao Song Zihao Song Yongjie Ma Yongjie Ma Yinqing Wang Yinqing Wang Chuan He Chuan He Guilin Li Guilin Li Peng Zhang Peng Zhang Tao Hong Tao Hong Liyong Sun Liyong Sun Peng Hu Peng Hu Ming Ye Ming Ye Hongqi Zhang Hongqi Zhang Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders Frontiers in Surgery arteriovenous fistula arteriovenous shunt craniocervical junction spinal vascular malformation subarachnoid hemorrhage |
| title | Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders |
| title_full | Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders |
| title_fullStr | Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders |
| title_full_unstemmed | Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders |
| title_short | Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders |
| title_sort | arteriovenous fistulas in the craniocervical junction region with vs without spinal arterial feeders |
| topic | arteriovenous fistula arteriovenous shunt craniocervical junction spinal vascular malformation subarachnoid hemorrhage |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1076549/full |
| work_keys_str_mv | AT zihaosong arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT zihaosong arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT yongjiema arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT yongjiema arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT yinqingwang arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT yinqingwang arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT chuanhe arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT chuanhe arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT guilinli arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT guilinli arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT pengzhang arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT pengzhang arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT taohong arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT taohong arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT liyongsun arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT liyongsun arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT penghu arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT penghu arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT mingye arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT mingye arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT hongqizhang arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders AT hongqizhang arteriovenousfistulasinthecraniocervicaljunctionregionwithvswithoutspinalarterialfeeders |