Purpose
Intracranial dural arteriovenous fistulas (DAVFs) can cause various symptoms from tinnitus to fatal cerebral hemorrhage (1).
Aggressive symptoms are related to the drainage pattern of the DAVFs,
and the DAVFs with cortical venous drainage should be aggressively treated (2).
A majority of cases with symptomatic and/or high risk DAVFs has been treated by endovascular techniques,
including transarterial embolization and/or transvenous embolization (1).
Precious evaluation of angioarchitecture including feeding arteries,
shunted pouches,
and draining vein of DAVFs by angiography is essential for successful result.
However,
it...
Methods and Materials
We retrospectively analyzed 15 consecutive patients with intracranial DAVFs who underwent rotational cerebral angiography and were subsequently treated between August 2010 and November 2012.
Characteristics of the 15 patients were summarized in table 1.
The patients’ ages ranged from 41 to 80 years (mean age,
63 years),
and there were 9 males and 6 females.
In one patient with transverse-sigmoid sinus (TSS) DAVFs,
another DAVFs developed at the superior sagittal sinus after the TSS DAVFS cured by transvenous embolization during this period.
Therefore,
16DAVFs were...
Results
MPR and partial MIP images of 3D-fusion angiography clearly demonstrated feeding arteries,
shunted pouches,
and draining vein in all but one patient.
Regarding the visualization of feeding arteries,
small feeding arteries running very closely to the bony structure or trasosseously could be depicted on 3D fusion angiography more clearly than 3D digital angiography in 10 lesions (Fig.
2-8) (Fig.
9-16) (Fig 24-27).
In 5 lesions,
feeding arteries were well depicted on both 3D fusion angiography and 3D digital angiography. In the remaining 1 lesion in...
Conclusion
Endovascular treatment,
including transarterial embolization and transvenous embolization,
has become the first-line option for the treatment of most cases of intracranial DAVFs.
Recent reports of transarterial embolization using liquid embolic materials such as ONYX and glue showed high curative rates of DAVFs especially for Cognard’s type IIb and type III DAVFs (7) (8).
However,
serious complications including cranial nerve injury,
distal migration,
and embolization of cerebral arteries due to migration of glue via the dangerous anastomosis have also been reported (9-11).
Therefore,
it is very...
References
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Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage.
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Aadland TD,
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3D C-arm conebeam CT angiography as an adjunct in the precise anatomic characterization of spinal dural arteriovenous fistulas.
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