Recurrence of initial angiographic occlusion in intracranial dural arteriovenous fistulas

作者：Xin Su, Yongjie Ma, Huishen Pang, Zihao Song, Huiwei Liu, Chao Zhang, Yiguang Chen, Beichuan Zhao, Mingyue Huang, Liyong Sun, Guilin Li, Peng Hu, Tao Hong, Ming Ye, Hongqi Zhang, Peng Zhang · 发表于：Journal of neurosurgery · 年份：2025 · DOI：10.3171/2025.3.jns25203 · 被引用次数：5 · 研究领域：Vascular Malformations Diagnosis and Treatment、Meningioma and schwannoma management、Intracranial Aneurysms: Treatment and Complications

OBJECTIVE: Recurrence after an initial angiography-determined cure of dural arteriovenous fistula (DAVF) has been reported, with risk factors identified in a few studies; however, some findings remain controversial. The objective of this study was to evaluate a large cohort of patients with DAVFs to estimate the recurrence rate and identify factors influencing recurrence. METHODS: Patient data for this study were derived from the Dural Arteriovenous Fistula Research and Management in China (DREAM-INI) database, compiled from a single-center retrospective study conducted in China. This analysis included only patients in whom an immediate complete cure was achieved who had subsequent angiographic follow-up. Two patient groups were compared: patients in whom a sustained durable cure was achieved and those who experienced recurrence following the initial cure. In addition to comparing baseline characteristics and follow-up results, potential risk factors for recurrence were examined and a time-to-recurrence analysis was performed. RESULTS: Among the 1101 patients included in the DREAM-INI dataset, 510 met the inclusion criteria for this study. Of these, 41 patients with an initially cured DAVF had 47 recurrence events; 48.8% developed new fistulas at distant sites, 36.6% had in situ recurrence, and 14.6% had both types of recurrence. The overall recurrence rate was 8.0%, with anticipated recurrence rates of 13.9% at 36 months and 24.1% at 105 months. Recurrence was more frequentl...