Risk-reduction strategies for endovascular treatment of falcotentorial dural AVFs
| Category | Risk-Reduction Strategy | Patients Treated |
|---|---|---|
| Anatomic assessment; to identify supply from ADS | Magnified high-frame-rate angiography | 1–6 |
| 3D rotational angiography with multiplanar reconstructions | 1–6 | |
| Transarterial embolization; strategies to avoid reflux across ADS | Initial embolization from non-ADS arterial supplies (to reduce competitive flow) | 1–6 |
| Close monitoring for linear reflux anteriorly from the vein of Galen (along the expected course of ADS) | 1–6 | |
| Embolization directly via ADS; strategies to treat via ADS while avoiding reflux | Direct cannulation of ADS with embolization if distal access achieved (pressure-cooker technique to minimize reflux) | 2 |
| Aborting embolization attempts from ADS if distal access not achieved (insufficient safety margin) | 1 | |
| Strategies for residual ADS supply | Staged embolization over multiple sessions as required | 1, 3, 5 |
| Transvenous approach (eg, reverse pressure-cooker technique) | 1 |