• World Neurosurg · Feb 2019

    Review

    Current status of endovascular treatment for dural arteriovenous fistulas in the superior sagittal sinus region: a systematic review of the literature.

    • Kun Hou, Tiefeng Ji, Yunbao Guo, Baofeng Xu, Kan Xu, and Jinlu Yu.
    • Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China.
    • World Neurosurg. 2019 Feb 1; 122: 133-143.

    BackgroundDural arteriovenous fistulas (DAVFs) occurring in the superior sagittal sinus (SSS) region are difficult to cure. Endovascular treatment (EVT) is an effective method for the treatment of SSS region DAVFs. Currently, no systematic review of EVT for SSS region DAVFs is available. A systematic review of the literature is necessary.MethodsA systematic PubMed search for studies related to SSS region DAVFs published after 1990 in English was performed on October 15, 2018.ResultsThirty-three studies involving 42 patients, including 31 (73.8%, 31/42) men, were finally identified. Of the 42 patients, 12 (28.6%, 12/42) patients mainly presented with intracranial hemorrhage, and 9 (21.4%, 9/42) patients presented with cognitive impairment. Of the 42 patients, 31 (73.8%, 31/42) patients were treated via transarterial embolization, and 11 (26.2%, 11/42) patients were treated via transvenous embolization. Of the 42 patients, 41 (97.6%, 41/42) patients had a clear angiographic outcome, and complete angiographic cure was achieved in 36 (87.8%, 36/41) patients. Of the 42 patients, 4 (9.5%, 4/42) patients were reported to have procedural complications. Of the 42 patients, 37 (88.1%, 37/42) patients had a definite description of the follow-up outcome, 22 (59.5%, 22/37) patients had a modified Ranking Scale score of 0, and 12 (32.4%, 12/37) patients had an improved neurologic state.ConclusionsIn treating SSS region DAVFs, EVT can completely obliterate the fistula point and correct venous shunting. Thus, currently EVT is an effective treatment for SSS region DAVFs. Although many complications can occur, this approach achieves good outcomes in most cases.Copyright © 2018 Elsevier Inc. All rights reserved.

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