Endovaskularno liječenje intrakranijskih arteriovenskih fistula

master's thesis

• Title (english): Endovascular treatment of intracranial arteriovenous fistulas
• Author: Petra Knežević
• Mentor: David Ozretić (mentor)
• Committee member: Goran Pavliša (predsjednik povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Committee member: David Ozretić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Intrakranijske duralne arteriovenske fistule (DAVF) patološki su spojevi između duralnih arterija i duralnih venskih sinusa, kortikalnih vena ili meningealnih vena. DAVF čine 10 do 15% svih intrakranijskih vaskularnih malformacija. Najčešće se radi o stečenim lezijama nepoznate etiologije čija je pojava povezana s trombozom intrakranijskih venskih sinusa koja vodi u razvoj venske hipertenzije. DAVF se kategoriziraju pomoću Cognardove i Bordenove klasifikacije, koje u obzir uzimaju lokalizaciju lezija i lokalizaciju venske drenaže, angiostrukturu, prisutnost/odsutnost kortikalne venske drenaže i smjer protoka krvi. Korištenjem postojećih klasifikacija, određuje se tip lezije na temelju čega se odabire vrsta terapijskog liječenja. Klinička prezentacija varira ovisno o lokaciji lezija i tipu venske drenaže, što obuhvaća raspon od asimptomatskih lezija sve do potencijalno smrtonosnih lezija uslijed rupture i cerebralnog krvarenja. Digitalna suptrakcijska angiografija predstavlja zlatni standard dijagnostike DAVF. Terapijske mogućnosti uključuju konzervativno liječenje, radiokirurško liječenje, endovaskularne intervencije i operativno liječenje, pri čemu se odluka temelji na čimbenicima poput tipa lezije, lokacije lezije i pacijentove osobne anamneze i trenutnog stanja. Prva linija liječenja fistula je endovaskularna intervencija, transarterijskim ili transvenskim putem, s ciljem kompletnog zatvaranja fistule kako bi se uklonili simptomi i prevenirale potencijalne komplikacije.

Abstract (english)

Intracranial dural arteriovenous fistulas (DAVF) are pathological connections between dural arteries and dural venous sinuses, cortical veins, or meningeal veins. DAVFs constitute 10 to 15% of all intracranial vascular malformations. They are most commonly acquired lesions of unknown etiology, whose occurrence is associated with intracranial venous sinus thrombosis leading to the development of venous hypertension. They are classified using the Cognard and Borden classifications, which take into account the localization of lesions and venous drainage, angioarchitecture, presence/absence of cortical venous drainage, and direction of blood flow. The type of the lesion is determined using available classifications, which helps decide which therapeutic option to use. The clinical presentation varies depending on the location of the lesions and the type of venous drainage, ranging from asymptomatic lesions to potentially fatal lesions due to rupture and cerebral hemorrhage. Digital subtraction angiography is the gold standard for diagnosing DAVFs. Therapeutic options include conservative treatment, radiation therapy, endovascular interventions, and surgical treatment, with the decision based on factors such as the type and location of the lesion, and the patient's personal history and current condition. The first-line treatment for fistulas is endovascular intervention, either transarterial or transvenous, aiming for complete fistula closure to cure the symptoms and prevent potential complications.

• Keywords: digitalna suptrakcijska angiografija; duralne arteriovenske fistule; endovaskularna embolizacija
• Keywords (english): digital subtraction angiography; dural arteriovenous fistulas; endovascular embolization
• Language: croatian
• URN:NBN: urn:nbn:hr:105:309133
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-21 09:09:25