TY - JOUR
T1 - The VEBAS score
T2 - a practical scoring system for intracranial dural arteriovenous fistula obliteration
AU - CONDOR Investigators
AU - Becerril-Gaitan, Andrea
AU - Ding, Dale
AU - Ironside, Natasha
AU - Buell, Thomas J
AU - Kansagra, Akash P
AU - Lanzino, Giuseppe
AU - Brinjikji, Waleed
AU - Kim, Louis
AU - Levitt, Michael R
AU - Abecassis, Isaac Josh
AU - Bulters, Diederik
AU - Durnford, Andrew
AU - Fox, W Christopher
AU - Blackburn, Spiros
AU - Chen, Peng Roc
AU - Polifka, Adam J
AU - Laurent, Dimitri
AU - Gross, Bradley
AU - Hayakawa, Minako
AU - Derdeyn, Colin
AU - Amin-Hanjani, Sepideh
AU - Alaraj, Ali
AU - van Dijk, J Marc C
AU - Potgieser, Adriaan R E
AU - Starke, Robert M
AU - Peterson, Eric C
AU - Satomi, Junichiro
AU - Tada, Yoshiteru
AU - Abla, Adib A
AU - Winkler, Ethan A
AU - Du, Rose
AU - Lai, Pui Man Rosalind
AU - Zipfel, Gregory J
AU - Chen, Ching-Jen
AU - Sheehan, Jason P
N1 - © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/2/12
Y1 - 2024/2/12
N2 - BACKGROUND: Tools predicting intracranial dural arteriovenous fistulas (dAVFs) treatment outcomes remain scarce. This study aimed to use a multicenter database comprising more than 1000 dAVFs to develop a practical scoring system that predicts treatment outcomes.METHODS: Patients with angiographically confirmed dAVFs who underwent treatment within the Consortium for Dural Arteriovenous Fistula Outcomes Research-participating institutions were retrospectively reviewed. A subset comprising 80% of patients was randomly selected as training dataset, and the remaining 20% was used for validation. Univariable predictors of complete dAVF obliteration were entered into a stepwise multivariable regression model. The components of the proposed score (VEBAS) were weighted based on their ORs. Model performance was assessed using receiver operating curves (ROC) and areas under the ROC.RESULTS: A total of 880 dAVF patients were included. Venous stenosis (presence vs absence), elderly age (<75 vs ≥75 years), Borden classification (I vs II-III), arterial feeders (single vs multiple), and past cranial surgery (presence vs absence) were independent predictors of obliteration and used to derive the VEBAS score. A significant increase in the likelihood of complete obliteration (OR=1.37 (1.27-1.48)) with each additional point in the overall patient score (range 0-12) was demonstrated. Within the validation dataset, the predicted probability of complete dAVF obliteration increased from 0% with a 0-3 score to 72-89% for patients scoring ≥8.CONCLUSION: The VEBAS score is a practical grading system that can guide patient counseling when considering dAVF intervention by predicting the likelihood of treatment success, with higher scores portending a greater likelihood of complete obliteration.
AB - BACKGROUND: Tools predicting intracranial dural arteriovenous fistulas (dAVFs) treatment outcomes remain scarce. This study aimed to use a multicenter database comprising more than 1000 dAVFs to develop a practical scoring system that predicts treatment outcomes.METHODS: Patients with angiographically confirmed dAVFs who underwent treatment within the Consortium for Dural Arteriovenous Fistula Outcomes Research-participating institutions were retrospectively reviewed. A subset comprising 80% of patients was randomly selected as training dataset, and the remaining 20% was used for validation. Univariable predictors of complete dAVF obliteration were entered into a stepwise multivariable regression model. The components of the proposed score (VEBAS) were weighted based on their ORs. Model performance was assessed using receiver operating curves (ROC) and areas under the ROC.RESULTS: A total of 880 dAVF patients were included. Venous stenosis (presence vs absence), elderly age (<75 vs ≥75 years), Borden classification (I vs II-III), arterial feeders (single vs multiple), and past cranial surgery (presence vs absence) were independent predictors of obliteration and used to derive the VEBAS score. A significant increase in the likelihood of complete obliteration (OR=1.37 (1.27-1.48)) with each additional point in the overall patient score (range 0-12) was demonstrated. Within the validation dataset, the predicted probability of complete dAVF obliteration increased from 0% with a 0-3 score to 72-89% for patients scoring ≥8.CONCLUSION: The VEBAS score is a practical grading system that can guide patient counseling when considering dAVF intervention by predicting the likelihood of treatment success, with higher scores portending a greater likelihood of complete obliteration.
U2 - 10.1136/jnis-2023-020282
DO - 10.1136/jnis-2023-020282
M3 - Article
C2 - 37130751
SN - 1759-8478
VL - 16
SP - 272
EP - 279
JO - Journal of Neurointerventional Surgery
JF - Journal of Neurointerventional Surgery
ER -