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A new transvenous approach to the carotid-cavernous sinus via the inferior petrooccipital vein.
MedLine Citation:
PMID:  21682561     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Object The transvenous approach via the inferior petrosal sinus (IPS) is commonly used as the most appropriate for carotid-cavernous fistula (CCF) or cavernous sinus sampling. However, sometimes the IPS is not accessible because of anatomical problems and/or complications, therefore an alternative route is needed. In this paper, the authors present and discuss the utility of a transvenous approach to the cavernous sinus via the inferior petrooccipital vein. Methods Four patients, 3 with dural CCFs and the other with Cushing disease, in whom endovascular surgical attempts failed using a conventional venous approach via the IPS, underwent a transvenous approach to the cavernous sinus via the inferior petrooccipital vein (IPOV). One dural CCF case had only cortical venous drainage, the second CCF also mainly drained into the cortical vein with slight inflow into the superior ophthalmic vein and inferior ophthalmic vein, and the third demonstrated drainage into the superior and inferior ophthalmic veins and IPOV. Results In all cases, the cavernous sinus could be accessed successfully via this route and without complications. Conclusions The transvenous approach to the cavernous sinus via the IPOV should be considered as an alternative in cases when use of the IPS is precluded by an anatomical problem and there are no other suitable venous approach routes.
Authors:
Akira Kurata; Sachio Suzuki; Kazuhisa Iwamoto; Kuniaki Nakahara; Madoka Inukai; June Niki; Kimitoshi Satou; Masaru Yamada; Kiyotaka Fujii; Shinichi Kan; Toshiro Katsuta
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-17
Journal Detail:
Title:  Journal of neurosurgery     Volume:  -     ISSN:  1933-0693     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Neurosurgery and.
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