Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR): Endovascular Treatment Outcomes for Tentorial Dural Arteriovenous Fistulae

Introduction: Tentorial dural arteriovenous fistulas (dAVFs) are aggressive and often require immediate treatment upon diagnosis. This study analyzes a large cohort of patients with tentorial dAVFs treated endovascularly through the Consortium for Dural Arteriovenous Fistula Outcomes Research (CONDOR).

Methods: Data was retrospectively analyzed from an international, multicenter cohort of patients treated for tentorial dAVFs with endovascular embolization from 2017 to 2024. Patient demographics and presentation, anatomic features of the dAVF, and complications and outcomes related to endovascular treatment were identified.

Results: Of 157 patients with diagnosis of tentorial dAVF, 92 received embolization as the sole treatment (mean age 58.3 years; 72.8% males). At diagnosis, 59.8% had a favorable functional status (mRS 0–1), despite 48.9% presenting with hemorrhage and 28.3% with non-hemorrhagic neurological deficits (NHND). Arterial feeders were predominantly from the middle meningeal and occipital arteries (65.2% each), with 93.5% showing cortical venous drainage and 40.2% showing venous ectasia Single-session embolization sufficed for 70.7% of patients, with a minority requiring multiple sessions. Favorable outcomes were common, with 82.6% complication-free cases, a low recurrence rate (8.7%), and 9.8% unplanned intervention rate. At last follow-up, 71.8% had a favorable mRS score (0–1). Complications were higher in patients presenting with NHND compared to those without (34.6% vs 5%; p=0.003) and in non-hemorrhagic cases compared to hemorrhagic cases (27.7% vs 2.3%; p=0.0009).

Conclusion : This large, multi-center study further characterizes anatomic features and clinical presentation of tentorial dAVF. In select patients, embolization as the sole treatment for these lesions is possible with many demonstrating favorable outcomes, low recurrence, high functional recovery, and most patients requiring only one treatment session. Hemorrhagic cases had fewer complications than non-hemorrhagic, and presentation with NHND was associated with higher complication rates.