Study Population

We retrospectively reviewed our institutional data base (Asan Medical Center) of patients who underwent endovascular treatment for CSDAVFs from January 2002 to September 2017 (n = 126). Feeding arteries, fistula locations, and their venous drainage patterns were evaluated by reviewing diagnostic cerebral angiography before endovascular treatment. Two biplane angiography systems (Artis zee; Siemens, Erlangen, Germany) were used for image acquisition and endovascular treatment.

Among those patients with CSDAVFs, the ones included in this study met the following criteria: 1) angiographic complete occlusion of the IPS either ipsilateral to the fistula side or bilateral IPS occlusions, and 2) primary treatment attempted with TVE via the occluded IPS, which had been probed with a 0.035-inch guidewire. Exclusion criteria for this study were the following: 1) angiographic patency of the ipsilateral IPS, or 2) catheterization of the occluded IPS with a microguidewire and microcatheter, without prior probing with a 0.035-inch guidewire.

A total of 52 patients met the inclusion criteria. General characteristics of the cohort are summarized in the Table. Therapeutic alternatives were discussed as a multidisciplinary decision-making process. Informed procedural consent had been obtained from patients before they underwent endovascular treatment. Institutional review board approval was obtained for this retrospective study.

Characteristics of the 52 patients in the study population