Table 1.
Summary of treatment strategies and outcomes for foramen magnum arteriovenous fistulas
| Treatment technique | No of cases (n=29) | No with sufficient follow-up data (n=26) | Clinical presentation | Immediate post-treatment cure rate | Durable cure rate (>3 month angiogram) | Clinical improvement | Complications | |
|---|---|---|---|---|---|---|---|---|
| Endovascular treatment (21/29, 72.4%) | TV | 16/29 (55.2%) | 14/16 (87.5%) | PT (n=15) Ocular symptoms (n=5) |
16/16 (100.0%) | 13/14 (92.9%) | Complete 10/14 (71.4%) partial 4/14 (28.6%) |
1/14 (7.1%) |
| TA | 3/29 (10.3%) | 2/3 (66.%) | SAH (n=2) PT (n=1) |
Complete 2/3 (66.7%) Partial 1/3 (33.3%) |
2/2 (100%) | 2/2 (100%) | 0/3* | |
| TA/TV | 2/29 (6.9%) | 2/2 (100%) | PT (n=2) PT+ocular symptoms (n=1) |
Complete 2/2 (100%) | Complete 2/2 (100%) | Complete 0/2 (0.0%) Partial 2/2 (100%) |
1/3 (33.3%) | |
| Surgical or endovascular+surgical treatment | 3/29 (10.3%) | 3/3 (100%) | Myelopathy (n=1) SAH (n=1) PT (n=1) |
Complete 3/3 (100%) | Complete 3/3 (100%) | Complete 3/3 (100%) | 1/3† (33%) | |
| No treatment | 5/29 (17.2%) | 4/5 (80.0%) | Asymptomatic (n=1) PT (n=4) |
Spontaneous cure (n=1) No follow-up (n=1) Treatment deferred or forthcoming (n=3) |
NA | Complete (n=1) Unknown (n=2) Ongoing/multiple AVF (n=3) |
N/A |
*
One patient died of unrelated causes several weeks after treatment.
†
Complication (distal branch occlusion) occurred during diagnostic angiography, no clinical sequelae were evident.
AVF, arteriovenous fistula; PT, pulsatile tinnitus; SAH, subarachnoid hemorrhage; TA, transarterial; TV, transvenous.