Transarterial embolization of dural arteriovenous fistula of the inferior petrosal sinus: A report of two cases

Dural arteriovenous fistula (DAVF) of the inferior petrosal sinus (IPS) is very unusual. Endovascular embolization is a good option for the treatment of DAVF. Until now, DAVFs of the IPS have only been reported sporadically. We reported two such cases. Case 1 was a 48-year-old man with headache and diplopia. Angiography confirmed a DAVF of the distal IPS, mainly supplied by the occipital artery (OA), and the IPS was occluded, which retrogradely drained into the cavernous sinus (CS) and then into the cortical vein. The DAVF in case 1 was embolized completely via the OA to cast Onyx-18. Case 2 was a 69-year-old female who had red and swollen eyes. Angiography confirmed a DAVF of the proximal IPS, mainly supplied by the accessory meningeal artery (AMA), which drained into the CS and then into the ophthalmic vein, and the IPS was occluded. The DAVF in case 2 was embolized completely via the AMA to cast Onyx-18. After treatment, these two patients had uneventful recoveries. In our report, these two cases indicated that the DAVFs of the proximal and distal IPS shared different origins of feeding arteries. When the IPS is occluded, the transarterial approach via the main feeder, such as OA and AMA, can be feasible to cure the DAVF of the IPS.