Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
World Neurosurg. 2024 Jul;187:122-123. doi: 10.1016/j.wneu.2024.04.050. Epub 2024 Apr 19.
Because histopathological aspects of dural arteriovenous fistulas (DAVFs) are often lacking, there can be controversies regarding their angioarchitecture. Depending on various statements or DAVF types, the shunts can be situated directly on the sinuses, at the confluence of sinuses and cortical veins, in adjacent vascular structures surrounding the sinus, or, even, in the bone. Comprehensive knowledge of the intricate arteriovenous shunt anatomy is crucial for the secure and effective management of DAVFs. It has been confirmed that the dural arteries communicate with crack-like veins that connect ≥1 dural veins near the affected sinuses. In DAVFs, it is certain that ≥1 draining veins exist before draining into the venous sinus, in contrast to the commonly stated direct artery-to-sinus communication. Arteries branch and taper, and veins receive branches and thicken their lumens. We define fistulous points as the locations where the feeding arteries transition from thick to thin and the draining veins transition from thin to thick. We provide an image description based on superselective angiography.
由于硬脑膜动静脉瘘（DAVF）的组织病理学表现常常缺乏，因此其血管结构可能存在争议。根据各种描述或 DAVF 类型，分流可以直接位于窦内、窦和皮质静脉汇合处、窦旁相邻的血管结构内，甚至在骨内。全面了解复杂的动静脉分流解剖结构对于 DAVF 的安全有效治疗至关重要。已经证实，硬脑膜动脉与裂隙样静脉相通，这些静脉连接受累窦附近的≥1 条硬脑膜静脉。与通常所说的直接动脉-窦沟通不同，在 DAVF 中，在引流至静脉窦之前，肯定存在≥1 条引流静脉。动脉分支变细，静脉接受分支并增粗其管腔。我们将瘘口定义为供养动脉从厚变薄、引流静脉从薄变厚的部位。我们根据超选择性血管造影提供图像描述。
