Neurology · Surgery ·
CONDOR Registry Reports Outcomes in 37 Cognard Type V Dural Fistulas
This retrospective analysis of 37 patients with Cognard type V dural arteriovenous fistulas drew on a 16-center multinational registry. Embolization was the most common initial treatment; complete obliteration rates varied by treatment, and most patients had a modified Rankin Scale score of 2 or lower at follow-up.
- Type V lesions accounted for 3% of registry dAVFs.
- Embolization was the most common primary treatment.
- Complete obliteration rates varied by treatment approach.
- One permanent treatment-related complication was reported.
Cognard type V dural arteriovenous fistulas (dAVFs), which drain into spinal perimedullary veins, are rare and can cause substantial neurological morbidity. Researchers retrospectively reviewed angiographically confirmed cases in the multinational CONDOR registry, comprising 16 academic centers. Of 1,077 patients with dAVFs, 37 (3%) had type V lesions; mean age was 57 years, and 59.5% were male. Nonhemorrhagic neurological deficits were the most common presentation (68%); 14% presented with hemorrhage.
Embolization was the primary treatment in 67% of patients, with complete obliteration reported in 71%. Upfront microsurgery was used in 22%, with an 88% obliteration rate, while radiosurgery was used in 14%, with a 40% success rate. Salvage treatment further improved obliteration outcomes. Temporary complications occurred in 3 of 37 patients (8%); one patient (3%) had a permanent complication due to treatment-related hemorrhage.
At a mean follow-up of 2.4 years, 24 of 35 patients (69%) maintained or improved to an mRS score of 2 or lower, and no deaths were reported. The authors describe favorable functional outcomes with timely, multimodal intervention. The findings are based on a small, retrospective cohort and do not establish comparative superiority among treatments; treatment selection and outcomes may vary across patients.
In practice
For patients with angiographically confirmed Cognard type V dAVFs, this registry describes embolization, microsurgery, radiosurgery, and salvage treatment as approaches used in practice, with reported obliteration rates differing across modalities. Most assessed patients had an mRS score of 2 or lower at a mean 2.4 years, and treatment-related complications were uncommon in this cohort. These retrospective data from only 37 patients do not establish which treatment is best or support a change in management; individualized decisions remain important.
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Journal of Neurosurgery: Intracranial dural arteriovenous fistulas with perimedullary venous drainage: analysis of the multinational CONDOR registry ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.