PTA Stent of Dural Sinuses in Brain DAVF: A Report of 4 Cases

Leonardo Renieri, Caterina Michelozzi, Waleed Brinjikji, Jean Darcout, Adrien Guenego, Ivan Vukasinovic, Philippe Tall, Fabrice Bonneville, Anne Christine Januel, Christophe Cognard

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background and Purpose: Type I and IIa dural arteriovenous fistulas (DAVFs) have a low hemorrhagic risk, but are often the cause of debilitating tinnitus that requires treatment. While Onyx® and PHIL™ (Precipitating hydrophobic injectable liquid) transarterial embolization represent the first endovascular option, there are occasional cases where performing angioplasty and stenting of the affected sinus may lead to satisfactory results. Material and Methods: We retrospectively analyzed four consecutive cases of patients with DAVF-induced pulsatile tinnitus secondary to type I and II DAVFs who were treated with angioplasty and stenting of the sinus only. All the patients had clinical and radiological long-term follow-up. Results: We noticed a significant radiological and clinical improvement in all the cases. Of the patients two were completely cured at follow-up with eradication of the neurological symptoms as well as the fistula, one was retreated with Onyx® for a very small residual shunt despite having no more tinnitus, and one showed improvement in venous drainage (from type IIa+b to type I fistula) without resolution of the fistula. Conclusion: In cases of type I and II DAVFs associated with sinus stenosis, angioplasty and stenting alone seem to be safe and effective. This treatment probably compresses the venules within the sinus walls, promoting thrombosis of the shunts thus solving the underlying cause of the fistula.

Original languageEnglish (US)
Pages (from-to)331-339
Number of pages9
JournalClinical Neuroradiology
Volume29
Issue number2
DOIs
StatePublished - Jun 1 2019
Externally publishedYes

Keywords

  • PTA stent
  • Sinus stenting
  • Treatment of DAVF
  • Type I fistula

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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    Renieri, L., Michelozzi, C., Brinjikji, W., Darcout, J., Guenego, A., Vukasinovic, I., Tall, P., Bonneville, F., Januel, A. C., & Cognard, C. (2019). PTA Stent of Dural Sinuses in Brain DAVF: A Report of 4 Cases. Clinical Neuroradiology, 29(2), 331-339. https://doi.org/10.1007/s00062-017-0652-2