Intracranial Dural Arteriovenous Fistulas: The Sinus and Non-Sinus Concept

Abstract Introduction: Dural arteriovenous fistulas (dAVFs) account for 10–15% of all intracranial lesions. Different classification strategies have been proposed in the course years. None them seems to guide treatment strategy. Objective: We expose experience vascular group at Niguarda Hospital and we propose a very practical method based on location shunt. divide dAVF sinus non-sinus order simplify our daily practice, as this is simply involvement sinuses. Material Methods: 477 dural treated. 376 underwent endovascular 101 surgical treatment. Cavernous DAVFs Galen ampulla malformations excluded from series they represent different pathology per se. dAVFs treated by approach: 180 were 179 non-sinus. with 15 86 Discussion: Of recorded mortality severe disability was 3% morbidity less than 4%. All patients postoperative DSA nearly 100% complete occlusion fistula. At mean follow-up 5 years one case there fistula recurrence, due presence partial clipping “piè” vein. Conclusions: The concept has guided institution led good clinical results. This paper intends share neurosurgical community.