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Endovascular Treatment of Cranial Dural Arterio-Venous Fistulas

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PanVascular Medicine

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Abstract

Intracranial dural arteriovenous fistulas (DAVFs) are relatively rare, acquired, pathologic shunts between dural arteries and dural venous sinuses, meningeal veins, or cortical veins. Signs and symptoms are highly variable and depend upon several factors including fistula location, duration of disease, and venous drainage pattern. The most clinically important feature for classification is venous drainage pattern. Management decisions require a multidisciplinary approach involving discussions among interventional neuroradiologists, neurosurgeons, and neurologists and depend on the type of lesion, including location and angiographic risk strata, assessment of clinical presentation, and patient status (age, comorbidities). Treatment should be pursued for all lesions with cortical venous drainage or intolerable symptoms.

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Abbreviations

Borden classification:

Classification system of dural arteriovenous fistulas where by these lesions are grouped into three types based upon the site of venous drainage and the presence or absence of cortical venous drainage.

Cognard classification:

Classification system of dural arteriovenous fistulas that correlates venous drainage patterns with increasingly aggressive neurological clinical course.

Compression therapy:

Non-invasive method to treat cavernous sinus dural arteriovenous fistulae.

Dural arteriovenous fistulas:

An abnormal direct connection between a meningeal artery and a meningeal vein or dural venous sinus.

NBCA:

N-Butyl Cyanoacrylate is a liquid embolic used in the treatment of cerebral vascular malformations.

Onyx:

Non-adhesive liquid embolic agent used for the pre-surgical embolization of cerebral vascular malformations.

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Further Readings

  • Guedin P, Gaillard S, Boulin A, Condette-Auliac S, Bourdain F, Guieu S, Dupuy M, Rodesch G (2010) Therapeutic management of intracranial dural arteriovenous shunts with leptomeningeal venous drainage: report of 53 consecutive patients with emphasis on transarterial embolization with acrylic glue. J Neurosurg 112(3):603–610. doi:10.3171/2009.7.JNS08490

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Authors and Affiliations

  1. Departments of Radiology and Neurosurgery, Presbyterian Hospital, Columbia University, 710 West 168th Street, Rm 428, New York, NY, 10032, USA

    Dr. Charles A. Bruno Jr. (Neurointerventional Fellow) & Daniel H. Sahlein (Associate Professor of Clinical Radiology)

  2. Neuroendovascular Services, Departments of Radiology and Neurosurgery, Presbyterian Hospital, Columbia University, New York, NY, USA

    Philip M. Meyers (Associate Professor of Radiology and Neurological Surgery; Clinical Co-Director)

Authors
  1. Dr. Charles A. Bruno Jr.
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  2. Daniel H. Sahlein
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  3. Philip M. Meyers
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Corresponding author

Correspondence to Daniel H. Sahlein .

Editor information

Editors and Affiliations

  1. Akademisches Lehrkrankenhaus MLU, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Bruno, C.A., Sahlein, D.H., Meyers, P.M. (2014). Endovascular Treatment of Cranial Dural Arterio-Venous Fistulas. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_97-1

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  • DOI: https://doi.org/10.1007/978-3-642-37393-0_97-1

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  • Online ISBN: 978-3-642-37393-0

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