P086 Utility of 3D cone beam CT in the management of spinal vascular malformations

<h3>Introduction</h3> The spatial understanding of spinal vascular malformations is traditionally based on high-resolution 2D DSA. 3D CBCT has the potential to further elucidate the pathophysiological anatomy of spinal vascular malformations, which is a prerequisite for targeted interventional or surgical therapy. <h3>Aim of Study</h3> To investigate the added diagnostic value of 3D CBCT in spinal vascular malformations. <h3>Methods</h3> Between 2019 and 2024, 10 patients with spinal vascular malformations underwent 3D CBCT as part of spinal DSA. CBCT findings were correlated with high-resolution intraoperative microscopic images including ICG video angiography. <h3>Results</h3> Nine patients with spinal dAVFs and 1 patient with spinal AVM were investigated. In all patients, CBCT led to a more comprehensive understanding of the lesion anatomy and its relationship to the healthy vascular system. The studies were correlated with intraoperative findings in 9/10 patients (pending treatment in 1 patient). Successfull occlusion of the lesions was confirmedin 8/9 patients (1 lost on F/U). <h3>Conclusion</h3> The use of CBCT in spinal vascular malformations yields new insights into normal and pathologic anatomy. It provides superior visualization of the fistula and its relationship with spinal cord vessels, which is a prerequisite for targeted endovascular or surgical treatment. <h3>Disclosure of Interest</h3> yes Educational &amp; Travel Grants: Stryker, Balt, Medtronic.