Embolization of a dural arteriovenous fistula (DAVF)

Various treatment options

There are various treatment options for DAVF:

• Endovascular embolization: The most commonly used treatment is endovascular embolization. In this minimally invasive procedure, the malformation is reached and treated via the arteries and veins. During the procedure, we insert plastic tubes (catheters) through the femoral artery and vein into the vessels affected by the DAVF. We inject embolizing agents or introduce material that closes the vessels of the malformation.
• Neurosurgical treatment: In some cases it is possible to close the DAVF neurosurgically.
• Conservative treatment: In certain cases, conservative treatment (without surgery) is preferred. This is done after thorough consideration of the disease risks compared to the risks/success of invasive treatment.

Advantages and disadvantages

• Treatment of a dural AV fistula is indicated if it causes symptoms (e.g. pulse-synchronous tinnitus, headaches) and/or if the risk of cerebral hemorrhage is increased. These risks can be avoided with treatment.
• A “benign” dural AVF does not necessarily need to be treated if the associated risks of cerebral hemorrhage or brain damage are insignificant and if the patient has no symptoms.
• The alternatives to endovascular treatment are neurosurgical interventions or conservative therapy with a monitoring strategy.

Procedure

The first step is to make a diagnosis, decide on minimally invasive treatment and discuss it with you during the consultation. This is followed by a prompt treatment appointment, taking into account the urgency of the treatment and your specific wishes.

The hospital stay for the treatment lasts three to four days. You will arrive the morning before the procedure and we will assess the current findings and make the final preparations. We will be happy to answer any final questions. On the day of the procedure, you will be taken from the ward to one of our two operating theaters, where the surgical team will welcome you and perform the procedure.

Aftercare

Immediately after the procedure, you will be examined to make sure that everything went well. You will then be transferred to a specialized monitoring ward, where you will be cared for and monitored until the next day. On the following day, a magnetic resonance examination is performed to assess the results of the operation and rule out complications. Normally you will then return to the normal ward and after a further one or two days you will be able to go home after a specialist consultation. At this last meeting, appointments for check-ups and consultations are also made.