Changes in Angioarchitecture After Stereotactic Radiosurgery for Dural Arteriovenous Fistula

Benton Maglinger, M. Maher Hulou, Christopher J. McLouth, Madison Sands, Damodar Pokhrel, William H. St. Clair, Stephen Grupke, Justin F. Fraser

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Dural arteriovenous fistulae (DAVF) are intracranial vascular abnormalities encountered in neurosurgery practice. Treatment options are microsurgical disconnection, endovascular embolization and/or radiosurgery. Past studies have reported the efficacy, safety, and predictors of success of radiosurgery. In this study, we investigated the angioarchitecture of fistulae at the time of radiosurgery and how the anatomy changed in the time after treatment based on angiogram follow-ups. Methods: A retrospective analysis was performed on patients with angiographic diagnosis of DAVF treated with Gamma Knife radiosurgery (GKRS) between 2013 and 2018. Data collection included demographics, symptoms, grading scores, vascular anatomy, radiation data, treatment strategy, angiographic results, and length of patient follow-up. Results: Our study reports data on 10 patients with a total of 14 fistulae. On follow-up angiography, 8 (57%) had complete occlusion of the fistula with a median time to follow up of 19.5 months. The remaining 6 (43%) were deemed as near-complete occlusion of fistula with a median time to follow up of 12.0 months. Time from radiosurgery to angiogram revealing incomplete vs. angiogram revealing complete obliteration was significantly different (p=0.045). Nearly all AVFs had decreased feeders over time after treatment with only one AVF developing an additional feeder post-treatment. Arterial feeders, drainage site, sex, Borden type, lesion volume and treatment volume had no predictive value of obliteration outcome. Conclusions: This study provides data on the angioarchitecture of fistulae treated with GKRS and also serves as an extension of previous studies reporting the safety and efficacy of GKRS treatment for DAVF in a specific patient population.

Original languageEnglish
Article number105676
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number5
StatePublished - May 2021

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Inc.


  • Angiography
  • Dural arteriovenous fistulae
  • Gamma knife
  • Radiosurgery

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Changes in Angioarchitecture After Stereotactic Radiosurgery for Dural Arteriovenous Fistula'. Together they form a unique fingerprint.

Cite this