title: Epidemiology of Dural Arteriovenous Fistula in Japan: Analysis of Japanese Registry of Neuroendovascular Therapy (JR-NET2).
abstract: We developed the Japanese Registry of Neuroendovascular Therapy 2 (JR-NET2) database and used the information for a retrospective, nation-wide multicenter, observational study to clarify the clinical characteristics, current status of procedures, and outcome of patients treated by neuroendovascular therapy in Japan. In this report, we analyzed the clinical characteristics of dural arteriovenous fistulas (dAVFs) in the JR-NET2 database. All patients with dAVFs treated with endovascular therapy in 150 Japanese hospitals were included. Patient characteristics, clinical presentations, and imaging characteristics were analyzed. A total of 1,075 patients with dAVFs underwent 1,520 endovascular procedures. Of 1,075 patients, 45% were men and 55% were women. The mean age was 65±13 years. The most frequent location of dAVFs was the cavernous sinus (43.6%), followed by the transverse-sigmoid sinus (TSS) (33.4%). Twelve percent of the patients had intracranial hemorrhage, 9% had venous infarction, and 3% had convulsion. The statistically significant independent risk factors of intracranial hemorrhage were TSS, superior sagittal sinus (SSS), tentorium, anterior cranial fossa, cranio-cervical junction, cortical venous reflux (CVR), and varix. Risk factors of venous infarction were age older than 60 years, male sex, TSS, SSS, and CVR. Risk factors of convulsion were male sex, SSS, and CVR. This is the largest nationwide report, to date, of the clinical characteristics of dAVFs treated by neuroendovascular therapy. CVR was a major risk factor of aggressive symptoms.
authors.forename: Masafuni
authors.initials: M
authors.lastname: Hiramatsu
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugiu
authors.forename: Tomohito
authors.initials: T
authors.lastname: Hishikawa
authors.forename: Jun
authors.initials: J
authors.lastname: Haruma
authors.forename: Koji
authors.initials: K
authors.lastname: Tokunaga
authors.forename: Isao
authors.initials: I
authors.lastname: Date
authors.forename: Naoya
authors.initials: N
authors.lastname: Kuwayama
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020785:Central Nervous System Vascular Malformations / Q000453:epidemiology* / Q000628:therapy*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D044583:Neuroendoscopy; D012042:Registries; D012189:Retrospective Studies