Intracranial dural arteriovenous fistula following venous sinus stenting: A case series and literature review.

BACKGROUND

While several theories describe the pathophysiology of dural arteriovenous fistulas (DAVF), their true causes and development remain debated. There are a few documented cases of DAVF formation following venous sinus stenting (VSS) in the literature. Here, we present a case series of DAVF formation after VSS and provide a literature review to further emphasize their association.

METHODS

We conducted a retrospective analysis of patient data with DAVFs following VSS at our department and performed a review of the relevant literature. Baseline characteristics of the patients and DAVFs, along with the locations of venous sinus thrombosis, VSS, and DAVF, as well as treatment details and outcomes, were collected.

RESULTS

The study included 4 men and 5 women, with a mean age of 43.8 years (range, 22-60 years). All cases involved stenosis or occlusion of the right transverse/sigmoid sinus (TSS), with each patient receiving stent placement in the right TSS. DAVFs were located at the same site as the stent placement, specifically in the right TSS. In 8 cases, the time to DAVF detection following stent placement was documented, with a mean duration of 6.4 months (range, 3-15 months). Conservative management was administered to two patients, while the remaining patients, underwent endovascular therapy due to severe clinical symptoms.

CONCLUSION

The development of DAVF following VSS highlights the critical role of venous hypertension or venous thrombosis in fistula formation, emphasizing the need for physician awareness and vigilance.