Dural arteriovenous fistulas

Abstract

While technique is important, understanding the vascular anatomy of the dAVF is paramount to a successful outcome. The use of the term “shunt” versus “fistula” allows a better depiction and frequently an improved understanding of the pathology that is encountered. Shunting further explains why the incomplete treatment of these unique lesions can result in increased vascular recruitment and delayed recurrence of the lesion. While venous sacrifice is a viable therapeutic option for those lesions involving the major sinuses, other locations lend themselves well to a transarterial approach. The advent of liquid embolic agents with less potential for adhesion has made transarterial closure of pathological dural arteriovenous shunts a safe and permanent option when treatment is indicated.