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Dural Arteriovenous Fistula (dAVF) and Caroticocavernous Fistula (CCF)

Dural arteriovenous fistula (dAVF) is a condition where abnormal vascular connections develop over time along the surface of the brain or spine between high-pressure arteries supplying the fibrous protective dura mater and the usually low-pressure draining veins. It results in abnormal high pressure and pulsatile arterial flow in the veins which often become significantly enlarged and distended. Occasionally a dAVF develops in a large vein directly behind the eye and is referred to as a caroticocavernous fistula (CCF).

Dural arteriovenous fistula may be asymptomatic however patients may frequently experience pulsatile tinnitus, headaches and visual disturbances. Brain haemorrhage, seizures and other neurologic symptoms can occur in high grade dAVF and require more urgent treatment.

The endovascular dAVF repair procedure involves General Anaesthesia and then internal access to the abnormal artery and vein using an artery in the wrist or upper leg. Using sophisticated navigation systems, the dAVF can be repaired internally with a combination of platinum coils and unique glue-like substances that progressively block the abnormal connection of vessels between the artery and vein allowing them to return to normal pressures and function. If successfully treated before damage has occurred the brain and spine can return to normal function with little or no deficit.

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