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

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 co...

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Bibliographic Details
Main Authors: Maximilian Thormann, Roland Schwab, Anastasios Mpotsaris, Maciej Powerski, Daniel Behme
Format: Article
Language:English
Published: Korean Society of Interventional Neuroradiology 2025-07-01
Series:Neurointervention
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Online Access:http://neurointervention.org/upload/pdf/neuroint-2025-00262.pdf
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Summary: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.
ISSN:2093-9043
2233-6273