Endovascular strategies for carotid cavernous and intracerebral dural arteriovenous fistulas

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Interventional neuroradiology is a less invasive modality than open neurosurgery for the treatment of a wide range of neurovascular disorders. Refinements in technique and improvements in the design of microcatheters, guide wires, and embolic materials have yielded superior clinical outcomes and provided an impetus to treat more of these lesions endovascularly rather than surgically. Endovascular therapy is the standard of care for direct and indirect carotid artery cavernous sinus fistulas and may also be curative for dural arteriovenous fistulas (AVFs) in other locations.

The authors provide review of the clinical features, pathophysiology, and management of intracranial AVFs focusing on contemporary endovascular treatment options.

Abbreviations used in this paper:CA = carotid artery; CACF = CA cavernous fistula; CCA = common CA; DAVF = dural arteriovenous fistula; ECA = external CA; ICA = internal CA; VA = vertebral artery.

Interventional neuroradiology is a less invasive modality than open neurosurgery for the treatment of a wide range of neurovascular disorders. Refinements in technique and improvements in the design of microcatheters, guide wires, and embolic materials have yielded superior clinical outcomes and provided an impetus to treat more of these lesions endovascularly rather than surgically. Endovascular therapy is the standard of care for direct and indirect carotid artery cavernous sinus fistulas and may also be curative for dural arteriovenous fistulas (AVFs) in other locations.

The authors provide review of the clinical features, pathophysiology, and management of intracranial AVFs focusing on contemporary endovascular treatment options.

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Article Information

Address reprint requests to: Randall T. Higashida, M.D., University of California at San Francisco Medical Center, Room L352, 505 Parnassus Avenue, San Francisco, California 94143-0628. email: randall.higashida@radiology.ucsf.edu.

© AANS, except where prohibited by US copyright law.

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