Percutaneous transluminal sinus angioplasty for transverse sinus-sigmoid sinus stenosis associated with recurrent dural arteriovenous fistula: Case report

Objective: Dural arteriovenous fistula (dAVF) is occasionally developed concomitantly or subsequently with sinus thrombosis and stenosis, and the causal relationship between them has been discussed. We report herein a patient of dAVF complicated by severe sinus stenosis who was treated with percutaneous transluminal sinus angioplasty. Case: A 34-year-old woman was treated for transverse sinus-sigmoid sinus (TS-SS) thrombosis and subsequent dAVF. A further dAVF occurred at the confluence associated with left TS stenosis. Intracranial venous circulation was impaired and the shunt flow drained to the deep venous systems. After percutaneous transluminal sinus angioplasty, venous flow congestion clearly decreased. Follow-up angiogram showed neither development of dAVF nor re-stenosis of the sinuses. Conclusion: Percutaneous transluminal sinus angioplasty for sinus stenosis associated with DAVF is effective to improve venous congestion and venous hypertension.