Department of Neurosurgery, The First Hospital of Jilin University, Changchun, 130021, China.
Department of Neurology, The First Hospital of Jilin University, Changchun, 130021, China.
Int J Med Sci. 2018 Oct 20;15(14):1600-1610. doi: 10.7150/ijms.27683. eCollection 2018.
Most intracranial dural arteriovenous fistulae (DAVFs) involve the transverse-sigmoid sinus (TSS), and various types of endovascular treatment (EVT) have been involved in managing TSS DAVFs. A current, comprehensive review of the EVT of TSS DAVFs is lacking. This study used the PubMed database to perform a literature review on TSS DAVFs to increase the current understanding of this condition. For high-grade TSS DAVFs such as Borden type 3, the goal of EVT is curative treatment. However, for low-grade TSS DAVFs such as Borden type 1 and some Borden type 2 TSS DAVFs, symptom relief or elimination of cortical reflux may be sufficient. Currently, EVT has become the first-line treatment for TSS DAVFs, including transarterial embolization (TAE), transvenous embolization (TVE) or both. TAE alone and TSS balloon-assisted TAE are also commonly used. However, TVE for TSS DAVFs is recognized as the most effective treatment, including coil direct packing TSS, Onyx (ethylene vinyl alcohol copolymer) TVE, and balloon-assisted Onyx TVE, which are commonly applied. In addition, TSS reconstructive treatment can be an effective procedure to treat TSS DAVFs. EVT is accompanied with complications, including technique- and treatment-related complications. Although complications may occur, TSS DAVFs have an acceptable prognosis after EVT.
大多数颅内硬脑膜动静脉瘘（DAVF）涉及横窦（TSS），各种类型的血管内治疗（EVT）已被用于治疗 TSS DAVF。目前，对 TSS DAVF 的 EVT 缺乏全面的综述。本研究使用 PubMed 数据库对 TSS DAVF 进行了文献回顾，以增加对该疾病的现有认识。对于高分级 TSS DAVF，如 Borden 3 型，EVT 的目标是根治性治疗。然而，对于低分级 TSS DAVF，如 Borden 1 型和一些 Borden 2 型 TSS DAVF，症状缓解或消除皮质反流可能就足够了。目前，EVT 已成为 TSS DAVF 的一线治疗方法，包括经动脉栓塞（TAE）、经静脉栓塞（TVE）或两者兼有。单纯 TAE 和 TSS 球囊辅助 TAE 也很常用。然而，TVE 被认为是治疗 TSS DAVF 的最有效方法，包括直接线圈包装 TSS、Onyx（乙烯-乙烯醇共聚物）TVE 和球囊辅助 Onyx TVE，这些方法都很常用。此外，TSS 重建治疗也可以是治疗 TSS DAVF 的有效方法。EVT 伴随着并发症，包括技术和治疗相关的并发症。尽管可能会发生并发症，但 TSS DAVF 经 EVT 后预后良好。
