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Abstract 1122‐000118: Covered Stent Placement for Treatment of a Dural Arteriovenous Fistula: Case Report and Literature Review


 Introduction
 : Dural arteriovenous fistula (AVF) is a condition that can cause significant venous congestion, subarachnoid and/or intracranial hemorrhage. Endovascular treatment typically targets embolization of feeding arteries with the use of coils, adhesive or sclerotic agents. The purpose of this study is to illustrate a case of a dural AVF that underwent novel treatment via transvenous stenting with a Viabahn covered stent and review the current literature on this topic.
 
 
 Methods
 : Existing literature was searched using PubMed, Embase and Google Scholar using the terms covered stent and dural arteriovenous fistula.
 
 
 Results
 : 69‐year‐old female presents with pulsatile tinnitus, right scalp and ear pain. Diagnostic cerebral angiography performed revealing a right temporal dural AV fistula with feeding arteries from right external carotid artery (ECA) branches, right vertebral artery and right meningohypophyseal trunk (MHT) draining into transverse sinus. Therapeutic angiogram performed using a heparin‐coated (viabahn) covered stent and discharged home on aspirin monotherapy.
 
 A total of 1363 articles were yielded from the above search. There were 3 case series that included patients with similar pathology and endovascular approach as our case. Treatment included transvenous placement of stent +/‐ angioplasty. None of the cases used a covered stent. The use of open stents can lead to low DAVF obliteration rate, 43% cure rate combined series. There are no current randomized clinical trials investigating treatment of dural AVF with covered stents.
 
 Conclusions
 : ITreatment of dural AVF via transvenous approach with a heparin‐coated covered stent can an alternative option compared to open stents that may lead to higher DAVF obliteration rate. Covered stenting of dural venous sinus may be a cost‐effective alternative to sinus sacrifice.
