Case Report: Sequential Transarterial and Trans-Cortical Venous Embolization of a Mixed Pial-Dural AVM

Endovascular therapy is the primary treatment modality for dural arteriovenous fistulas. Pre-treatment angiographic evaluation of dural fistulas must rule out the presence of a mixed pial component or supply from pial-dural collaterals, as the pial supply must be closed before definitive occlusion of the draining vein to prevent iatrogenic rupture. In this report, we described a case of a mixed pial-dural arterial venous malformation (AVM), which was effectively treated with a sequential transarterial and trans-cortical venous embolization.