Management of aggressive cerebral dural arteriovenous fistulae: Experience using endovascular embolisation

Objectives : This retrospective study was aimed at assessing our results of endovascular management in aggressive cerebral DAVFs. Materials and Methods : This is a retrospective study of 22 patients with 25 dural fistulae who underwent endovascular treatment with trans-arterial EVOH or transvenous coiling between January 2013 and October 2016. Results : In the group treated by transarterial EVOH, complete exclusion of the fistulae was achieved at the end of embolisation in 18 out of 22 fistulae, 3 out of 22 fistulae had slow residue which occluded on their control angiograms leading to a cure rate of 95%.  Two of the three patients who underwent transvenous coiling had stable and complete occlusion of their fistulae while the third required another treatment session using trans-arterial EVOH. Complications were seen in three patients. Conclusion: Endovascular embolisation is a safe, highly efficacious and low risk procedure for management of aggressive cerebral DAVFs