Purpose

This study investigated the clinical outcomes and follow-up results of venous sinus stenting (VSS) for constrictive dural sinus restoration in patients with intracranial dural arteriovenous fistulas (DAVFs). We hypothesized that this treatment would have durable benefits in such patients.

Methods

Patients who underwent VSS for DAVFs with cortical venous reflux between January 2008 and June 2020 were identified after a retrospective review (n =18). Clinical and endovascular treatment data and follow-up information were reviewed.

Results

The mean age of the 18 patients was 59.9 years. Stents were implanted in 10 previously occluded sinuses and 9 stenotic sinuses in addition to endovascular embolization. One patient received bilateral VSS. Subdural hemorrhage occurred in one patient after recanalization for embolization, followed by uneventful stenting. In 17 patients with clinical follow-up, the median follow-up time was 59.5 months (interquartile range 18 to 84 months). Of these, sixteen patients had follow-up vascular imaging, revealing AVF obliteration in 6 patients (38%) and stent patency in 11 (69%). Retreatment was performed for 8 (50%) patients. The mean follow-up modified Rankin scale score was 1.28. All patients had longstanding symptomatic improvement.

Conclusion

Restoration of sinus flow in DAVFs with cortical venous reflux through VSS has an acceptable complication rate and long-term symptomatic control; however, retreatment is often required, and stent occlusion is not uncommon.

中文翻译：

---

硬脑膜动静脉瘘辅助窦支架置入术的临床疗效

目的

本研究调查了颅内硬脑膜动静脉瘘 (DAVFs) 患者使用静脉窦支架置入术 (VSS) 进行缩窄性硬脑膜窦修复的临床结果和随访结果。我们假设这种治疗会对这些患者产生持久的益处。

方法

在回顾性审查后确定了 2008 年 1 月至 2020 年 6 月期间因 DAVF 伴皮质静脉反流而接受 VSS 的患者（n  =18）。审查了临床和血管内治疗数据和随访信息。

结果

18 名患者的平均年龄为 59.9 岁。除血管内栓塞外，还将支架植入 10 个先前闭塞的鼻窦和 9 个狭窄的鼻窦。一名患者接受了双侧 VSS。1 例患者在栓塞再通后发生硬膜下出血，随后支架植入顺利。在接受临床随访的 17 名患者中，中位随访时间为 59.5 个月（四分位距为 18 至 84 个月）。其中，16 名患者进行了随访血管成像，显示 6 名患者 (38%) 的 AVF 闭塞和 11 名 (69%) 的支架通畅。对 8 名（50%）患者进行了再治疗。平均随访改良 Rankin 量表评分为 1.28。所有患者都有长期的症状改善。

结论

通过 VSS 恢复皮层静脉回流的 DAVF 中的窦流量具有可接受的并发症发生率和长期症状控制；然而，通常需要再治疗，并且支架闭塞并不少见。