{
    "abstract": "This study presents a long-term single-centre experience with CS-DAVFs and discusses the historical progression, current state, and future directions of endovascular treatment.\nWe retrospectively reviewed all patients with CS-DAVFs endovascularly treated at our institution between 2006 and 2024. We evaluated clinical presentation, imaging findings, endovascular treatment techniques, and clinical improvement.\n63 patients underwent 68 endovascular procedures. 49 patients (72%) underwent transvenous procedures through the inferior petrosal sinus or ophthalmic veins. 39 fistulas (57%) were occluded using liquid embolic agents (LEAs) alone or in combination with coils. Eight patients (12%) required the injection of LEAs in the superior pharyngeal branch of the APA to reach the complete occlusion of the fistula. In 4 cases, the vascular anatomy of the fistula required the direct puncture of the draining vein. In 46 cases (68%), the fistula was successfully occluded using coils. Complete occlusion was achieved in 52 of the cases (77%), but two cases (3%) had fistula recurrence after the first treatment. We found one complication of the endovascular procedure in the study population. The median imaging follow-up time was 12 months (range 2-135); the median clinical follow-up was 32 months (range 1.5-194). 60 Patients (95%) showed persistent clinical improvement.\nEndovascular occlusion is the gold standard for CS-DAVFs, with high rates of occlusion and few complications. Continued advancements in techniques and devices are essential to improve outcomes and reduce complications.",
    "authors": [
        {
            "affiliation": "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.",
            "firstname": "Amedeo",
            "initials": "A",
            "lastname": "Cervo"
        },
        {
            "affiliation": "University Hospital, St. Poelten, Austria.",
            "firstname": "Branko",
            "initials": "B",
            "lastname": "Popadic"
        },
        {
            "affiliation": "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.",
            "firstname": "Antonio",
            "initials": "A",
            "lastname": "Macera"
        },
        {
            "affiliation": "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.",
            "firstname": "Claudia",
            "initials": "C",
            "lastname": "Rollo"
        },
        {
            "affiliation": "Ospedale Papa Giovanni XXIII, Bergamo, Italy.",
            "firstname": "Luca",
            "initials": "L",
            "lastname": "Quilici"
        },
        {
            "affiliation": "Ospedale San Carlo, Potenza, Italy.",
            "firstname": "Luca",
            "initials": "L",
            "lastname": "Valvassori"
        },
        {
            "affiliation": "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.",
            "firstname": "Mariangela",
            "initials": "M",
            "lastname": "Piano"
        },
        {
            "affiliation": "University Hospital, St. Poelten, Austria.",
            "firstname": "Camillo",
            "initials": "C",
            "lastname": "Sherif"
        },
        {
            "affiliation": "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.",
            "firstname": "Edoardo",
            "initials": "E",
            "lastname": "Boccardi"
        },
        {
            "affiliation": "ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. guglielmo.pero@gmail.com.",
            "firstname": "Guglielmo",
            "initials": "G",
            "lastname": "Pero"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",
    "doi": "10.1007/s00234-025-03561-w\n10.3171/2012.2.FOCUS1223\n10.3171/jns.1985.62.2.0248\n10.1227/01.NEU.0000153750.95524.62\n10.1136/neurintsurg-2016-012743\n10.1177/1591019917751894\n10.1016/j.jocn.2021.05.005\n10.2147/OPTH.S410930\n10.1016/S0161-6420(79)35454-9\n10.1177/15910199241272595\n10.1136/neurintsurg-2016-012742\n10.1016/j.jcma.2015.09.001\n10.1136/neurintsurg-2017-013318\n10.1007/s00062-019-00868-z\n10.1093/neuros/nyy486\n10.1136/neurintsurg-2018-014704\n10.1016/j.wneu.2020.10.001\n10.1016/j.wneu.2022.07.094\n10.5137/1019-5149.JTN.40189-22.2\n10.1007/s13760-023-02405-9\n10.1227/NEU.0000000000000751\n10.1007/s00062-016-0534-z\n10.1136/neurintsurg-2020-017118\n10.1007/s002340050566\n10.1136/neurintsurg-2013-011067.rep\n10.1136/neurintsurg-2016-012488\n10.1016/j.wneu.2018.06.098\n10.1016/j.bj.2023.100657\n10.1007/s12013-015-0615-7\n10.1007/s00062-022-01232-4\n10.1227/01.neu.0000316007.34259.26\n10.3389/fneur.2022.1078185\n10.5469/neuroint.2023.00493\n10.1007/s00234-009-0554-3\n10.1016/j.wneu.2017.10.026",
    "journal": "Neuroradiology",
    "keywords": [
        "Ascending pharyngeal artery",
        "Cavernous sinus",
        "Dural arteriovenous fistula",
        "Embolization",
        "Endovascular treatment",
        "Liquid embolic agents"
    ],
    "methods": null,
    "publication_date": "2025-02-17",
    "pubmed_id": "39960530\n3968564\n15730574\n29350092\n34119282\n545206\n31853611\n33049381\n35933096\n37885308\n37924471\n25830601\n27506673\n9580430\n29936206\n37660902\n25707503\n36478073\n18382318\n36712416\n38213194\n19578842\n29045854",
    "results": "63 patients underwent 68 endovascular procedures. 49 patients (72%) underwent transvenous procedures through the inferior petrosal sinus or ophthalmic veins. 39 fistulas (57%) were occluded using liquid embolic agents (LEAs) alone or in combination with coils. Eight patients (12%) required the injection of LEAs in the superior pharyngeal branch of the APA to reach the complete occlusion of the fistula. In 4 cases, the vascular anatomy of the fistula required the direct puncture of the draining vein. In 46 cases (68%), the fistula was successfully occluded using coils. Complete occlusion was achieved in 52 of the cases (77%), but two cases (3%) had fistula recurrence after the first treatment. We found one complication of the endovascular procedure in the study population. The median imaging follow-up time was 12 months (range 2-135); the median clinical follow-up was 32 months (range 1.5-194). 60 Patients (95%) showed persistent clinical improvement.",
    "title": "Eighteen-year journey in endovascular management of cavernous sinus DAVFs: advances, outcomes, and lessons learned.",
    "xml": "<Element 'PubmedArticle' at 0x788504eb50d0>"
}