How I do it: exoscopic disconnection of anterior fossa dural arteriovenous fistulae.

García-García, Sergio; Barić, Hrvoje; Pohjola, Anni; Lehecka, Martin · Acta Neurochir (Wien) · 2025

other · Level V

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Abstract

Brain Dural Arteriovenous Fistulae (DAVF) are acquired abnormal connections between dural arteries and cerebral veins or venous sinuses. Disconnection of the pathological shunt is recommended for high-grade fistulae and cases with intolerable symptoms or previous bleedings. Surgical disconnection remains the preferred method for anterior fossa DAVF. Microsurgical disconnection of anterior fossa DAVF is performed with the assistance of a robotic exoscope. Intraoperative aniography is implemented to confirm the exclusion of DAVF. The exoscope provides excellent lighting and magnification in challenging surgical fields improving surgeon's ergonomics and enabling tailored, minimally invasive approaches without compromising procedural safety or effectiveness.

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