Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis

• 出版年: Neurointervention
• 主要な著者: Maximilian Thormann, Roland Schwab, Anastasios Mpotsaris, Maciej Powerski, Daniel Behme
• フォーマット: 論文
• 言語: 英語
• 出版事項: Korean Society of Interventional Neuroradiology 2025-07-01
• 主題: central nervous system vascular malformations; sinus thrombosis; intracranial; stents
• オンライン･アクセス: http://neurointervention.org/upload/pdf/neuroint-2025-00262.pdf
• ISSN: 2093-9043; 2233-6273

Dural arteriovenous fistulas (dAVFs) are rare vascular malformations, often complicated by sinus thrombosis and cortical reflux. We report a patient with a Cognard Type IIb dAVF at the right transverse sinus and ipsilateral sigmoid sinus thrombosis, unsuitable for conventional embolization due to contralateral sinus hypoplasia. A novel therapeutic approach involving direct jugular vein puncture, venous recanalization, and stenting using a stiff 0.035-inch guidewire effectively downgraded the dAVF to Cognard Type I. At 3-month follow-up, stable angiographic outcomes, marked clinical improvement, and absence of seizures confirmed the efficacy of sinus stenting as a standalone treatment in an anatomically challenging case.