Objective: A case of cavernous dural arteriovenous fistula (DAVF) that was successfully treated by targeted transvenous embolization using 3D rotational angiography (3D-RA) is described. Clinical presentation: A 75-year-old woman presented with diplopia. Workup imaging indicated left cavernous DAVF with cortical venous reflux via the left superficial middle cerebral veins. Results: 3D-RA showed that all the dural feeding arteries converged into a small superior posterior-lateral compartment of the left cavernous sinus. Platinum coils were transvenously placed in the small compartment where the shunt existed for complete obliteration of the fistula and at the origin of the left superficial cerebral veins for obliteration of the cortical reflux. Conclusions: 3D-RA provided a better comprehension of angioarchitectural details as well as the location of the shunt and the origin of venous reflux. The delay time was considered to be one of the important parameters to obtain better 3D reconstructed images.
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