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In their article, Hendriks et al 1 present 20 isolated sinus dural arteriovenous fistulas (DAVFs) with multimodal approaches to achieve the complete occlusion of the fistulas. Transarterial embolization (TAE) with Onyx had a success rate of 66.7% and transvenous embolization (TVE) a success rate of 77.8%. All three open TVEs and one surgery resulted in complete closure of the fistulas. A middle meningeal artery rupture occurred during TAE, and a cerebellar hematoma occurred during TVE, necessitating craniectomy. Complete occlusion rate of the fistulas was 100% when followed up. The authors did not specify the recurrence rate of DAVFs in the article. Because digital subtraction angiography is the gold standard, we believe that some patients had a follow-up magnetic resonance angiography scan, which might overestimate the total complete occlusion and understate the recurrence …
Footnotes
Contributors Study conception and design: XS. Critically revising the article: ZS, YM, PZ. All authors read and approved the final manuscript.
Funding This study was funded by the National Natural Science Foundation of China (No. 82101460).
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.