Neurointervention (Jul 2025)

Venous Sinus Stenting Alone as an Effective Treatment for Complex Dural Arteriovenous Fistulas with Sinus Thrombosis

  • Maximilian Thormann,
  • Roland Schwab,
  • Anastasios Mpotsaris,
  • Maciej Powerski,
  • Daniel Behme

DOI
https://doi.org/10.5469/neuroint.2025.00262
Journal volume & issue
Vol. 20, no. 2
pp. 89 – 93

Abstract

Read online

Dural arteriovenous fistulas (dAVFs) are rare vascular malformations, often complicated by sinus thrombosis and cortical reflux. We report a patient with a Cognard Type IIb dAVF at the right transverse sinus and ipsilateral sigmoid sinus thrombosis, unsuitable for conventional embolization due to contralateral sinus hypoplasia. A novel therapeutic approach involving direct jugular vein puncture, venous recanalization, and stenting using a stiff 0.035-inch guidewire effectively downgraded the dAVF to Cognard Type I. At 3-month follow-up, stable angiographic outcomes, marked clinical improvement, and absence of seizures confirmed the efficacy of sinus stenting as a standalone treatment in an anatomically challenging case.

Keywords