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Twenty-six patients treated endovascularly for posterior fossa dural AVFs, type III, IV, or V, were included in this study. One hundred percent of the dural AVFs were occluded. A transarterial approach was performed in 23 dural AVFs; a combined transarterial and transvenous approach, in 2 dural AVFs; and a transvenous approach alone, in 1 dural AVF. The middle meningeal artery was the most common artery chosen to inject embolic liquid (12/26). Procedure-related morbidity was 15.4% at 24 hours, 7.7% at discharge, and 0% at 6 months. Procedure-related mortality was 0%. The authors conclude that endovascular treatment offers high occlusion rates for posterior fossa dural AVFs with low morbidity and mortality rates.

A group of 392 patients was analyzed (160 before versus 232 after January 2015). Distal balloon angioplasty was associated with the following: higher rates of angioplasty (43% versus 27%) and intravenous milrinone (31% versus 9%); lower rates of postangioplasty delayed cerebral infarction (2.2% versus 7.5%) and new angioplasty (8% versus 19%) independent of the rate of patients treated by angioplasty and milrinone; and the same rates of stroke related to angioplasty (3.6% versus 3.1%), delayed cerebral infarction (7.7% versus 12.5%), mortality (10% versus 11%), and favorable outcome (79% versus 73%). The authors conclude that distal balloon angioplasty is safe and decreases the risk of delayed cerebral infarction and the recurrence of vasospasm compared with conventional angioplasty. It fails to show a clinical benefit possibly because of confounding changes in adjuvant therapies of vasospasm during the study period.