Transarterial endovascular treatment of tentorial dural arteriovenous fistulas: a systematic review and meta-analysis

Purpose To quantitatively evaluate the efficacy and safety of transarterial endovascular treatment for tentorial dural arteriovenous fistulas through a systematic review and meta-analysis.Methods A systematic review and single-arm meta-analysis were conducted according to PRISMA guidelines and Cochrane recommendations. PubMed, Embase, and the Cochrane Library were searched up to 10 December 2025, for studies reporting angiographic, clinical, and safety outcomes of transarterial endovascular treatment for tentorial dural arteriovenous fistulas. Pooled proportions with 95% confidence intervals (CI) were calculated using random-effects models, and heterogeneity was assessed using the I2 statistic, τ2, and Cochran’s Q test.Results Ten independent observational cohorts comprised 450 patients, with extractable transarterial data for 371 and outcome-specific denominators. Pooled proportions were 81.2% (95% CI, 67.2–90.1%) for complete angiographic occlusion, 89.6% (82.1–94.1%) for favorable functional outcome, and 14.5% (9.7–21.0%) for overall complications. Among 161 patients, one procedure-related death and five all-cause deaths were reported; corresponding pooled proportions were 4.7% (2.0–11.0%) and 8.8% (4.1–17.9%). Mortality estimates were influenced by continuity corrections for zero-event studies. Disease-related mortality could not be separately quantified.Conclusion TAE was associated with high pooled occlusion and favorable functional outcome proportions, alongside clinically relevant complications. Overall confidence in the evidence is low because of observational designs and methodological limitations; no randomized trials were included. Comparative efficacy and safety remain uncertain.