title: Shunted pouches of cavernous sinus dural AVFs: evaluation by 3D rotational angiography.
abstract: BACKGROUND
  The aims of this study were to evaluate the angioarchitecture of cavernous sinus dural arteriovenous fistulas (CSdAVFs), including the number and location of shunted pouches (SPs), and to evaluate whether the location and number of the SPs affect the outcomes of transvenous embolization of CSdAVFs.
  
  
  METHODS
  Nineteen consecutive cases of CSdAVFs that underwent rotational angiography and transvenous embolization were reviewed. Multiplanar reconstruction images of rotational angiography and selective angiography were reviewed with particular interest in the SPs. Relationships of the locations and number of SPs with the results of transvenous embolization were statistically analyzed.
  
  
  RESULTS
  All cases showed SPs, with numbers ranging from 1 to 4 (mean, 2.2). The location of the SPs was "posteromedial" in 16, "posterolateral" in 13, "lateral" in 6, and "medial" in 3 patients. Six cases showed posteromedial SPs alone, and three cases showed posterolateral SPs alone. The other 10 cases showed multiple locations of SPs. All cases were treated by transvenous embolization with sinus packing (n = 11) or selective embolization of the SP (n = 8). Complete occlusion of dAVF was obtained in 16 cases immediately after embolization. Locations of SPs and drainage types were significantly associated with the immediate angiographic results (p < 0.01).
  
  
  CONCLUSIONS
  The SP of CSdAVFs is often multiple and is located posteriorly to the CS. The number and location of SPs affect immediate angiographic results of transvenous embolization.
authors.affiliation: Department of Radiology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Yufu City, Oita, Japan, 879-5593, hkiyosue@oita-u.ac.jp.
authors.forename: Hiro
authors.initials: H
authors.lastname: Kiyosue
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tanoue
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Hori
authors.forename: Norio
authors.initials: N
authors.lastname: Hongo
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002426:Cavernous Sinus / Q000000981:diagnostic imaging*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D002533:Cerebral Angiography / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012399:Rotation; D012680:Sensitivity and Specificity; D016896:Treatment Outcome