Endovascular treatment of cribriform plate dural arteriovenous fistulas: technical difficulties and complications avoidance

Abstract

Endovascular treatment of cribriform plate dAVF is safe and effective. The embolisation through ethmoidal artery is the method of choice. Branches of the middle meningeal artery are tortuous and prevent the penetration of embolic agent. Venous approach is effective but is limited to cases of failure of the arterial approach.

Current status of endovascular treatment for dural arteriovenous fistulae in the anterior cranial fossa: A systematic literature review

“…The ethmoidal branch (sphenopalatine artery) of the internal maxillary artery (IMA) was also involved in ACF DAVFs. In the studies considered in this series (Table 2), the rate of involvement of the ethmoidal branch of the IMA was 20-66% 4, 6, 9, 12, 37, 38. In the 48 cases, the overall rate was 33.3% 8, 11, 12, 23, 28, 30.…”

“…The MMA can be involved in ACF DAVFs and, when involved, is typically unilateral 14, 15, 37. In the considered ACF DAVF studies (Table 2), the rate of MMA involvement was 20-30% 4, 6, 9, 12, 37, 38.…”

“…Of all such venous drainage routes, the frontal cortical veins to the SSS are the most frequently affected 8, 9, 12. In the considered ACF DAVF studies (Table 2), the rate of drainage into the SSS was 60-100% 4, 6, 9, 12, 37, 38. In the 48 cases, the overall rate was 89.6%.…”

“…In ACF DAVFs, the sources of the main feeding arteries are the AEA of the OA and are primarily bilateral4, 5, 8, 9, 11, 24, 31, 37. In the considered ACF DAVF studies (Table 2), the involvement of the AEA of the OA was 93-100%, and 50-100% of ACF DAVFs had bilateral feeding arteries 4, 6, 9, 12, 37, 38. In the identified 48 cases, 97.9% of patients had feeding arteries from the AEA of the OA, and 83.3% of patients had bilateral feeding arteries.…”

Ethmoidal dural arteriovenous fistulas: endovascular transvenous embolization technique

“…However, they may have angiographic features that increase the risk of rupture: cortical venous drainage, venous ectasia, venous stenosis and high arterial flow. If the dAVF has these angiographic features, treatment may be indicated regardless of the clinical presentation 2–4. In this neurosurgical endovascular video 1, we present two patients with high-flow ethmoidal dAVFs treated via transvenous endovascular approaches.…”