The Effectiveness of Dural Venous Sinus Sacrifice as a Treatment of Aggressive Type Cranial Dural Arteriovenous Fistulas

OBJECTIVE: To evaluate the effectiveness of dural venous sinus sacrifice as a treatment of aggressive type cranial dural arteriovenous fistulas (dAVFs) in terms of both clinical outcome and angiographic outcome. MATERIALS AND METHODS: One hundred and twenty-eight patients with 163 aggressive type cranial dAVFs who were treated with dural sinus sacrifice were retrospectively reviewed. Clinical and angiographic outcomes were analyzed. Procedural complications were also recorded. Only 103 patients (80.5%) who had been following up for at least 90 days were analyzed for clinical outcome. RESULTS: There were 53 males and 75 females with age ranging from 20 years to 93 years (mean age 55.44 years). The overall angiographic cure rate of dural venous sinus sacrifice as a part of the treatment of aggressive dAVFs was 81.6%. Considering clinical outcome (average duration of follow-up was 2 years and 6 months), 75 patients (72.8%) had clinical improvement and 21 (20.4%) were clinically stable. Worsening of the presenting symptoms was observed in 7 patients (6.8%). Procedural complications were found in 5 patients (3.9%). CONCLUSION: Dural venous sinus sacrifice is a safe and effective treatment strategy with high angiographic cure rate, good clinical outcome, and low incidence of procedural-related complication.