Isolated sinus dural arteriovenous fistulas (DAVFs) constitute a rare and distinctive subtype of DAVF, typically found in small case numbers or case reports. The optimal treatment for this DAVF type remains unclear.

This study aims to further detail the treatment outcomes of isolated sinus DAVFs in a sizable cohort from a single center.

A retrospective study was undertaken on a consecutive series of patients with isolated sinus DAVFs treated at a single institution from 2002 to 2022. The article delineates the clinical presentation, angiographic features, treatment strategy, clinical and angiographic outcomes, and complications.

The cohort consisted of 31 males and 13 females, with an average age of 52.0 ± 15.5 years (range, 16–83). The success rate for trans-arterial embolization (TAE) was 97.3% (36/37). Transvenous embolization (TVE) with the reopening technique was successful in 3 of 4 patients (75.0%). Two open burr-hole TVE cases (66.7%, 2/3) and one surgery (100%) resulted in immediate complete closure of the fistula. Immediate complete occlusion was achieved in 93.2% (41/44) of cases. There was one major complication (2.3%, 1/44) and two fistulas recurred (9.5%, 2/21).

The majority of isolated sinus DAVFs can be effectively treated with TAE using Onyx. TVE and surgery serve as alternative techniques when arterial access is deemed inappropriate or when complete occlusion cannot be attained with TAE. Complete embolization of isolated sinus DAVFs by TAE can typically be achieved without delay.

中文翻译：

背景

孤立性窦性硬脑膜动静脉瘘 (DAVF) 是 DAVF 的一种罕见且独特的亚型，通常见于小病例数或病例报告。这种 DAVF 类型的最佳治疗方法仍不清楚。

本研究旨在进一步详细说明来自单个中心的相当大的队列中孤立性窦性 DAVF 的治疗结果。

对 2002 年至 2022 年在同一机构接受治疗的一系列孤立性窦 DAVF 患者进行了一项回顾性研究。文章描述了临床表现、血管造影特征、治疗策略、临床和血管造影结果以及并发症。

该队列由 31 名男性和 13 名女性组成，平均年龄为 52.0 ± 15.5 岁（范围为 16-83 岁）。经动脉栓塞（TAE）的成功率为97.3%（36/37）。4 名患者中，有 3 名 (75.0%) 的患者采用重新开放技术进行经静脉栓塞 (TVE) 成功。两例开放性钻孔 TVE 病例（66.7%，2/3）和 1 例手术（100%）导致瘘管立即完全闭合。93.2% (41/44) 的病例实现了立即完全闭塞。出现 1 例主要并发症（2.3%，1/44），2 例瘘管复发（9.5%，2/21）。

使用 Onyx 进行 TAE 可以有效治疗大多数孤立性窦性 DAVF。当动脉通路被认为不合适或 TAE 无法实现完全闭塞时，TVE 和手术可作为替代技术。TAE 对孤立性窦 DAVF 的完全栓塞通常可以立即实现。