Endovascular treatment of cerebral dural and pial arteriovenous fistulas

Neuroimaging Clin N Am. 2013 Nov;23(4):625-36. doi: 10.1016/j.nic.2013.03.010. Epub 2013 May 16.

Abstract

Dural arteriovenous fistulas (DAVFs) are arteriovenous shunts from a dural arterial supply to a dural venous channel, typically supplied by pachymeningeal arteries and located near a major venous sinus. Pial arteriovenous fistulas (PAVFs) are composed of one or more arterial feeders draining into a single vein in the absence of an intervening nidus. Fistulas manifesting features of high risk for rupture should be treated aggressively, the spectrum of treatment varies from endovascular, surgical resection, and stereotactic radiosurgery. This article describes the natural history, clinical presentation, and treatment of dural and pial fistulas, with emphasis on endovascular treatment.

Keywords: Arteriovenous; Dural; Embolization; Endovascular; Fistula; Pial.

Publication types

  • Review

MeSH terms

  • Central Nervous System Vascular Malformations / diagnosis
  • Central Nervous System Vascular Malformations / therapy*
  • Cerebral Revascularization / instrumentation
  • Cerebral Revascularization / methods*
  • Combined Modality Therapy
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Hemostatics / therapeutic use*
  • Humans
  • Intracranial Arteriovenous Malformations / diagnosis
  • Intracranial Arteriovenous Malformations / therapy*
  • Neuroimaging / methods
  • Pia Mater / blood supply
  • Pia Mater / surgery
  • Surgery, Computer-Assisted / methods

Substances

  • Hemostatics