• Keisuke Kadooka, Michihiro Tanaka, Yoshinori Sakata, Minoru Ideguchi, Maki Inaba, and Hiromu Hadeishi.
• Department of Neurosurgery, Kameda Medical Center, Chiba, Japan. Electronic address: kadosan0313@ybb.ne.jp.
• World Neurosurg. 2018 Jan 1; 109: 328-332.

BackgroundExact identification of feeding arteries, shunt points, and draining veins is essential in treating cavernous sinus dural arteriovenous fistula (CS dAVF). In addition to digital subtraction angiography (DSA) and 3-dimensional rotational angiography (3DRA), high-resolution cone beam computed tomography (CBCT; especially 80-kv high-resolution cone beam computed tomography) have been performed in recent years. We evaluated the efficacy of CBCT in treating CS dAVF.MethodsEight CS dAVFs were treated with endovascular embolization between January 2013 and December 2016. We retrospectively examined these cases regarding information from DSA, 3DRA, and CBCT with contrast medium.ResultsAlthough all procedures can evaluate feeding arteries, shunt points, and draining veins, CBCT can provide the best definition of feeders and their course through the bony structures and the compartment of CS. Therefore, CBCT with placed microcatheter in the CS can reveal whether the microcatheter is set at the appropriate compartment to be embolized.ConclusionsThe efficacy of CBCT in treating dAVF is illustrating the relationships among the bony structures and feeders, compartment of CS, and the position of the microcatheter. Detailed information obtained with CBCT can lead to fewer complications and more effective treatment.Copyright © 2017 Elsevier Inc. All rights reserved.

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