Hybrid interventions on cerebral dural arteriovenous fistulas with isolated segment of the venous sinus

Abstract

Introduction. In most cases, dural arteriovenous fistulas of the brain can be effectively treated endovascularly. However, rare fistulas with an isolated segment of the venous sinus may be difficult to treat surgically. Hybrid surgical interventions (combination of open surgical access to the sinus and puncture embolization in hybrid operating room) can significantly increase the effectiveness of surgical treatment of patients with this pathology.The objective was to improve the results of surgical treatment of patients with cerebral dural arteriovenous fistulas with isolated segment of the venous sinus by using a hybrid surgical intervention.Methods and materials. 2 surgical interventions were performed using microsurgical and endovascular methods. Surgical interventions were made in hybrid operating room.Results. Radical occlusion of dural arteriovenous fistulas was achieved in both cases. The postoperative period was favorable in both cases with positive dynamics in the neurological status.Conclusions. Hybrid interventions combining microsurgical and endovascular methods make it possible to achieve radical occlusion of “complex” cerebral dural arteriovenous fistulas with isolated segments of the venous sinus.