3D digital subtracted angiography venous roadmapping for endovascular management of dural venous stenosis

Stenting of the dural venous sinuses has emerged as a therapeutic option for intracranial hypertension and pulsatile tinnitus. However, venous endovascular navigation faces challenges due to lower-quality roadmaps compared to arterial navigation. This study explores the application of three-dimensional (3D) rotational venography in assessing the cerebral venous vasculature and its potential for venous navigation. The methods involve venous 3D digital subtracted angiography (DSA) in patients with dural venous stenosis, with image acquisition using a biplane angiographic system. The results highlight the enhanced spatial resolution of 3D venous imaging, providing anatomical information crucial for precise characterization of stenosis and understanding cortical venous drainage. 3D venous roadmapping is shown to improve endovascular venous navigation, offering synchronized and rotatable 3D roadmaps, providing a comprehensive approach to optimize endovascular venous interventions.