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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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
Subjects:
Online Access:http://neurointervention.org/upload/pdf/neuroint-2025-00262.pdf
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author Maximilian Thormann
Roland Schwab
Anastasios Mpotsaris
Maciej Powerski
Daniel Behme
author_facet Maximilian Thormann
Roland Schwab
Anastasios Mpotsaris
Maciej Powerski
Daniel Behme
author_sort Maximilian Thormann
collection DOAJ
description 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.
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institution OA Journals
issn 2093-9043
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language English
publishDate 2025-07-01
publisher Korean Society of Interventional Neuroradiology
record_format Article
series Neurointervention
spelling doaj-art-e45b3ed4e10343e883191b3122fbdc002025-08-20T02:35:47ZengKorean Society of Interventional NeuroradiologyNeurointervention2093-90432233-62732025-07-01202899310.5469/neuroint.2025.00262463Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus ThrombosisMaximilian Thormann0Roland Schwab1Anastasios Mpotsaris2Maciej Powerski3Daniel Behme4 Department of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany Department of Neuroradiology, University Hospital Magdeburg, Magdeburg, Germany Institute for Diagnostic and Interventional Radiology, Munich Hospital Harlaching, Munich, Germany Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany Department of Neuroradiology, University Hospital Magdeburg, Magdeburg, GermanyDural 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.http://neurointervention.org/upload/pdf/neuroint-2025-00262.pdfcentral nervous system vascular malformationssinus thrombosisintracranialstents
spellingShingle Maximilian Thormann
Roland Schwab
Anastasios Mpotsaris
Maciej Powerski
Daniel Behme
Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis
Neurointervention
central nervous system vascular malformations
sinus thrombosis
intracranial
stents
title Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis
title_full Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis
title_fullStr Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis
title_full_unstemmed Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis
title_short Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis
title_sort venous sinus stenting alone as an effective treatment for complex dural arteriovenous fistulas with sinus thrombosis
topic central nervous system vascular malformations
sinus thrombosis
intracranial
stents
url http://neurointervention.org/upload/pdf/neuroint-2025-00262.pdf
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