Updates in the management of cranial dural arteriovenous fistula

Stroke Vasc Neurol. 2019 Nov 21;5(1):50-58. doi: 10.1136/svn-2019-000269. eCollection 2020.

Abstract

Dural arteriovenous fistula (dAVF) accounts for approximately 10% of all intracranial vascular malformations. While they can be benign lesions, the presence of retrograde venous drainage and cortical venous reflux makes the natural course of these lesions aggressive high risk of haemorrhage, neurological injury and mortality. Endovascular treatment is often the first line of treatment for dAVF. Both transarterial and transvenous approaches are used to cure dAVF. The selection of treatment approach depends on the angioarchitecture of the dAVF, the location, the direction of venous flow. Surgery and, to a lesser extent, stereotactic radiosurgery are used when endovascular approaches are impossible or unsuccessful.

Keywords: dAVF; dural arteriovenous fistulas; embolisation; transarterial; transvenous.

Publication types

  • Review

MeSH terms

  • Central Nervous System Vascular Malformations / diagnostic imaging
  • Central Nervous System Vascular Malformations / mortality
  • Central Nervous System Vascular Malformations / physiopathology
  • Central Nervous System Vascular Malformations / therapy*
  • Cerebrovascular Circulation
  • Clinical Decision-Making
  • Embolization, Therapeutic* / adverse effects
  • Embolization, Therapeutic* / mortality
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / mortality
  • Humans
  • Neurosurgical Procedures* / adverse effects
  • Neurosurgical Procedures* / mortality
  • Radiosurgery* / adverse effects
  • Radiosurgery* / mortality
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome