Angioarchitecture of dural arteriovenous fistulas and the analysis of its therapeutic strategies / 中国脑血管病杂志

ABSTRACT

Objective: To discuss the angioarchitectual characteristics of dural arteriovenous fistulas (DAVFs) and its appropriate therapeutic strategies. Methods: A total of 159 patients with DAVFs were retrospectively analyzed, including the clinical presentations, patterns of angioarchitecture. The appropriate therapeutic strategies, and the factors affecting the efficacy of treatmen were analyzed. Results: The patients with DAVFs were treated with different approaches. Sixty-nine patients with their DAVFs were treated in the cavernous sinus area, including type I (n = 58) and type II (n = 11); 41 patients in the lateral sinus area, including type I (n = 26), type II (n = 14) and type III (n = 1); 13 patients in the superior sagittal sinus area, including type I (n = 1), type II (n = 2) and type III (n = 10); 20 in the tentorial area, and 7 in the skull base area were all type III. There were 9 patients with multiple DAVFs. The main therapeutic approaches used were endovascular treatment. Postoperative angiography demonstrated that 79 patients were cured, 71 improved, and 9 failed. Postoperative complications were found in 9 patients, among them 8 were cured or improved and 1 died. Conclusion: The clinical presentation, treatment and prognosis depend upon the angioarchitecture, the location and the venous drainage patterns. Endovascular treatment is the first choice and chief therapeutic approach.