Microsurgical management of dural arteriovenous fistulas draining into the superior petrosal veins
SHAO Ling-min
CHEN Gang
JIAN Zhi-hong
LIU Ren-zhong
Abstract：Objective To investigate the microsurgical methods and clinical outcomes of patients with dural arteriovenous fistulas(DAVFs)draining into the superior petrosal veins(SPVs).Methods A retrospective analysis was carried out on the clinical data of 10 patients with DAVFs draining into the SPVs who underwent microsurgery from January 2014 to December 2022.Results Preoperative cerebral angiography confirmed that 3 cases were drained through the left superior petrosal vein and 7 through the right.All patients adopted the suboccipital retrosigmoid approach.The fistula and the superior petrosal vein were successfully blocked after confirmation through intraoperative fluorescence angiography.Two cases underwent ventriculoperitoneal shunt due to hydrocephalus after the operation.Six months after the operation,cerebral angiography reexamination showed that the fistulas were completely occluded in 9 cases.The clinical follow-up ranged from 6 to 36 months.According to the GOS score:8 cases had good recovery,1 case had moderate disability,and 1 case had severe disability.Conclusion The suboccipital retrosigmoid approach can fully expose the superior petrosal vein.Combining preoperative image simulation and intraoperative fluorescence angiography for accurate localization of the fistula is the key to improving the surgical outcome for patients with DAVFs draining into the SPVs.
Keywords：Dural arteriovenous fistulaSuperior petrosal veinMicrosurgical managementSuboccipital retrosigmoid approachClinical efficacy
Publication Date：2024-11-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 641-645 )