Abstract 446: Transvenous Embolization along with Intraprocedural Image Fusion Technique for Complex Intracranial Dural Arteriovenous Fistula.

Background and purpose This study aimed to investigate the role and safety of intraprocedural flat‐detector computed tomography‐based rotational angiography and image fusion (FDCT‐RA and IF) in microcatheter navigation during transvenous treatment of dural arteriovenous fistulae (dAVF). Materials and methods We retrospectively reviewed 86 cases of dAVF treated by a transvenous approach between January 2009 and April 2023. The patients were classified into two groups according to the treatment technique used: the FDCT‐RA and IF technique group and the conventional technique group. Univariate analyses were performed to compare the two treatment modalities. Results The FDCT‐RA and IF technique was used in 37 of the 86 patients (43.0%). The FDCT‐RA and IF group showed significant differences in dAVF location, sinus occlusion state, and access routes compared to the conventional treatment group. The FDCT‐RA and IF technique was commonly used for dAVFs involving the anterior condylar confluence and cavernous sinus with ipsilateral inferior petrosal sinus (IPS) occlusion. The complete occlusion rate was higher in patients treated with this technique (n=34, 91.9%) than in those treated using the conventional technique (n=39, 79.6%). However, the difference was not statistically significant (p=0.136). Implementation of this technique during the treatment procedure showed a tendency to decrease both fluoroscopy duration and radiation dose. The obtained result was not statistically significant (p=0.315, p=0.130).