Hybrid Capability to Integrate Multiple Treatment Modalities for Managing High-Grade Intracranial Dural Arteriovenous Fistulas

Show full item record



Permalink

http://hdl.handle.net/10138/314481

Citation

Dillmann , J , Hafez , A , Niemelä , M & Braun , V 2019 , ' Hybrid Capability to Integrate Multiple Treatment Modalities for Managing High-Grade Intracranial Dural Arteriovenous Fistulas ' , World Neurosurgery , vol. 125 , pp. E774-E783 . https://doi.org/10.1016/j.wneu.2019.01.168

Title: Hybrid Capability to Integrate Multiple Treatment Modalities for Managing High-Grade Intracranial Dural Arteriovenous Fistulas
Author: Dillmann, Johannes; Hafez, Ahmad; Niemelä, Mika; Braun, Veit
Other contributor: University of Helsinki, HUS Neurocenter
University of Helsinki, Department of Neurosciences


Date: 2019-05
Language: eng
Number of pages: 10
Belongs to series: World Neurosurgery
ISSN: 1878-8750
DOI: https://doi.org/10.1016/j.wneu.2019.01.168
URI: http://hdl.handle.net/10138/314481
Abstract: BACKGROUND: An integrated multimodality approach can be effective in treatment of high-grade dural arteriovenous fistulas. Nevertheless, this requires a high level of efficient cooperation between different departments, underlying a degree of bias in the decisional process. In comparison, hybrid capability, integrating these modalities in one hand, may allow aggregating multimodality treatment strategies by pooling their individual benefits, leading to a more holistic view of the consequences of each modality. METHODS: We retrospectively reviewed 18 cases of dural arteriovenous fistulas subjected to a hybrid treatment approach at the Diakonieklinikum Jung-Stilling, Siegen, Germany, between March 2008 and January 2017. Nine cases were excluded. We selected 4 cases that highlight different aspects of hybrid capability for illustrative purposes. RESULTS: Hybrid capability allows treatment of a dural arteriovenous fistula based on the individual clinical situation of the patient and features of the lesion, free of interdepartmental bias. The surgeon maintains a level of flexibility that enables him or her to move from a minimally invasive endovascular approach to a maximally invasive surgical access according to the specific situation. Hybrid capability can lead to a highly efficient treatment regimen with palliation of symptoms and complete obliteration of the fistula, improving performance in these complex pathologies. CONCLUSIONS: Hybrid capability has great potential in the treatment of complex neurovascular lesions. It remains to be seen if a single surgeon with hybrid capability can supersede the current multidepartmental practice and achieve better outcomes.
Subject: Dural arteriovenous fistulas
Hybrid capability
Multimodality treatment
SURGICAL-TREATMENT
ONYX EMBOLIZATION
STEREOTACTIC RADIOSURGERY
ENDOVASCULAR TREATMENT
CLINICAL-COURSE
SURGERY
RISK
MANAGEMENT
ERA
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
Hybrid_capabili ... Arteriovenous_Fistulas.pdf 4.478Mb PDF View/Open
1_s2.0_S1878875019302682_main.pdf 3.702Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record