E-019 treatment of intracranial dural arteriovenous fistulas refractory to endovascular therapy with gamma knife radiosurgery

Abstract

Introduction We sought to review all cases of dural arteriovenous fistulas (AVFs) treated at our institution treated with Gamma Knife radiosurgery following failed endovascular management. Methods Patients with intracranial dural AVFs treated by Gamma Knife from 2000 to 2015 were evaluated retrospectively. These included Borden I–III lesions spanning any angioarchitecture. Patient’s clinical files, radiological images, catheter angiograms, and surgical reports were reviewed. Results 15 patients with dural AVFs treated by Gamma Knife radiosurgery were identified. All 15 patients treated reported either symptomatic palliation or cure of their symptoms. Angiographic cure, when present, occurred at a mean time of 2 years following radiosurgical treatment. There was no significant association between Borden type and cure-rate, and failed endovascular treatment was not associated with lower rates of palliation and cure. Conclusions The number of feeders supplying a lesions is associated with treatment challenge, whereas Borden type appears not to be. Stereotactic radiosurgery is a safe and effective method for the treatment of dural arteriovenous malformation both as a de novo approach or as an adjunct to endovascular embolotherapy. Disclosures A. Dmytriw: None. M. Schwartz: None. R. Agid: None.