P-023 3D venography in neurointerventional applications

Introduction 3D venography has been reported previously as an indirect imaging method for visualization of various intracranial venous structures (ex.cavernous sinus). The potential disadvantage of indirect venography is the quality of imaging information which can have large variations and the need for an additional intervention should that be necessary. We present a direct transvenous modality of imaging intra- and extra-cranial venous structures. Method A total of three patients have undergone direct 3D venography. Two of the patients had a venography for evaluation of cavernous venous structures and one patient was evaluated for a facial venous malformation. All patients underwent a direct injection of contrast within the structures to be imaged by a transvenous approach. A rotational venogram was performed and the raw data was postprocessed into 3D images. These were further analyzed. In two cases a transvenous intervention followed guided by the information obtained by direct 3D venography. Results All patients underwent the study succesfully and without complications. In all cases the venography was essential in either guiding the following intervention or predicting the likelihood of venous bleeding intra-operativelly. Conclusions 3D venography is a feasible technique with minimal added risks. The study can serve either as a guidance for further trans-venous interventions or as a predictor of intraoparative venous bleeding for trans-sphenoidal surgery. Competing interests None.