Front Line of the Treatment for Dural Arteriovenous Fistulas

Abstract

  The front line treatment for dural arteriovenous fistulas (dAVF) is discussed. Source images from time of flight MRI give the definite diagnosis of dAVF. Additionally, maximum intensity projection/multi-planar reconstruction images of 3D-digital subtraction angiography provide the localization of the dAVF. Regarding transvenous embolization, we must consider the development of instruments and techniques to allow the superselective obliteration of the dAVF with preservation of the involved sinus. Onyx is another consideration, which would improve the obliteration rate in difficult cases.