| Objective: To explore the safety and effectiveness of endovascular treatment of dural arteriovenous fistula in tentorium area.Methods: The clinical data of 28 patients with dural arteriovenous fistula in the tentorium area who were admitted to the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University from March 2015 to June 2021 were retrospectively analyzed.Eight patients had subarachnoid hemorrhage before operation.Among them,Glubran glue was used for embolization in 9 cases,Onyx glue was used for embolization in 17 cases,and Onyx glue was used for transarterial approach combined with transvenous approach for balloon-assisted embolization in 2 cases.The curative effect and operation-related complications were observed.All patients received endovascular treatment for the first treatment,and their clinical manifestations,imaging features,and methods of endovascular treatment were analyzed.Results: Among the 28 patients with tentorial DAVF embolization,22 cases were complete embolization,2 cases were subtotal embolization,1 case was partial embolization,and 3 cases embolization failed.One case had subacute right cerebellar hemisphere infarction due to Glubran reflux.The follow-up time was 5 months to 6 years,and the median follow-up time was 34 months(5 months to6 years).The symptoms of 19 patients were significantly improved,including 13 patients who were cured(the symptoms disappeared)and 6 patients whose symptoms improved.The symptoms of 9 patients had no obvious changes compared with those before operation.None of the 11 patients admitted to the hospital for DSA reexamination had recurrence.Conclusion: Endovascular therapy can be used as the first choice for the treatment of dural arteriovenous fistula in the tentorial area,with good curative effect and low surgical risk.Careful preoperative identification of vascular structural features and selection of an appropriate embolization route are the keys to successful surgery. |
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