EFFICACY OF ENDOVASCULAR INTERVENTIONS IN INTRACRANIAL DURAL ARTERIOVENOUS FISTULAS: A SYSTEMATIC REVIEW

Abstract

Objectives: To evaluate the efficacy and safety of endovascular interventions for the treatment of intracranial intracranial dural arteriovenous fistulas (DAVFs). Methods: A thorough search across four databases identified 881 relevant publications. After removing duplicates using Rayyan QCRI and screening for relevance, 475 full-text articles were reviewed, with 7 studies ultimately meeting the criteria for inclusion. Results: We included seven studies with a total of 455 patients and less than half of them 213 (46.8%) were females. Endovascular therapy can effectively block DAVFs, with rates ranging from 57.6% to 97.8%. The review emphasizes the relative safety of endovascular treatments for dural arteriovenous fistulas, with multiple studies showing low mortality rates. Despite this, concerns about procedure-related morbidity in certain cases, particularly where mortality is higher, highlight the risks linked to the technical and anatomical complexities of these procedures. Nonetheless, endovascular therapy is still considered a preferred initial treatment when surgery is not viable, advocating for continued improvements and tailored approaches to maximize safety and effectiveness. Conclusion: Endovascular treatment for intracranial DAVFs is a promising surgical alternative, demonstrating high success rates in obliteration and low mortality. However, the variability in morbidity rates highlights the need for enhanced techniques and better patient selection. Future studies, including prospective and randomized controlled trials, are essential to refine the use of endovascular therapies, improve patient outcomes, and reduce healthcare burdens.