A new transvenous approach to the carotid-cavernous sinus via the inferior petrooccipital vein

Kurata, Akira; Suzuki, Sachio; Iwamoto, Kazuhisa; Nakahara, Kuniaki; Inukai, Madoka; Niki, Jun; Satou, Kimitoshi; Yamada, Masaru; Fujii, Kiyotaka; Kan, Shinichi; Katsuta, Toshiro

doi:10.3171/2011.4.jns102155

Cited by 24 publications

(21 citation statements)

References 13 publications

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“…Another beak-like structure was identified adjacently but with the reference to the bone, this was found to be an extracranial structure being possibly the inferior petro-occipital vein. 5,6 In this specific case, the venography obtained by the 2D method could not show the precise location of the IPS-IJV junction as they overlap. Furthermore, the common opening of the IPS and the inferior petro-occipital vein could only be identified precisely using the 3D images.…”

Section: Materials Methods and Resultsmentioning

confidence: 96%

Transvenous embolization of cavernous sinus dural arteriovenous fistula through a thrombosed inferior petrosal sinus utilizing 3D venography

et al. 2015

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Objective We report a new technique in approaching the cavernous sinus through an occluded inferior petrosal sinus (IPS) using three-dimensional (3D) venography. Case presentation A patient diagnosed with arteriovenous fistula of the right cavernous sinus underwent transvenous embolization. The IPS was not detectable on angiogram. Retrograde injection of contrast with 3D imaging of the internal jugular vein clearly demonstrated the remnant of the IPS. By referring to the images obtained, catheterization of the cavernous sinus by way of the IPS was performed without difficulties. Conclusion Three-dimensional venography for detecting the entrance to the IPS is a useful method and easy to perform. We believe that this technique should be considered whenever the access to an occluded IPS is necessary.

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Section: Materials Methods and Resultsmentioning

confidence: 96%

Transvenous embolization of cavernous sinus dural arteriovenous fistula through a thrombosed inferior petrosal sinus utilizing 3D venography

et al. 2015

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“…Mitsuhashi et al 25 demonstrated the IPS drainage directly into the vertebral plexus with no connection to the IJV in 3/83 sides (3.6%) and the IPS was absent in 14/ 83 sides (16.9%). In our series also, absence of connection with the IJV was noted in one (10%) of 10 venous sampling procedures from the cavernous sinus in five patients 23 .…”

Section: Indications and Contraindications Of Each Proceduresmentioning

confidence: 89%

“…In our series, with two (cases 1 and 2) (11%) of 18 dural CCF patients the conventional venous approach via the IPS failed 23 . These two patients were referred to our institute more than 1 year after development of initial symptoms, which may have contributed to obstruction of the IPS with an organized old thrombus.…”

Section: Indications and Contraindications Of Each Proceduresmentioning

confidence: 99%

“…However, it may be that the IPS is not accessible because of anatomical problems and/or complications, so that an alternative route is needed. In this paper, we have presented and discussed the utility of a transvenous approach to the cavernous sinus via the inferior petrooccipital vein (IPOV) 23 .…”

Section: Contralateral Cavernous Sinus Approachmentioning

confidence: 99%

“…Transvenous approach to the carotid-cavernous via the inferior petrooccipital vein 23 The transvenous approach via the inferior perusal sinus (IPS) is commonly used as the most appropriate for carotid cavernous fistula (CCF) or cavernous sinus sampling. However, it may be that the IPS is not accessible because of anatomical problems and/or complications, so that an alternative route is needed.…”

Section: Contralateral Cavernous Sinus Approachmentioning

confidence: 99%

See 2 more Smart Citations

Endovascular Approaches to the Carotid Cavernous Sinus for Endovascular Treatment of Carotid Cavernous Fistulas and Hormone Sampling

Kurata¹

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Anatomy of the inferior petro‐occipital vein and its relation to the base of the skull: Application to surgical and endovascular procedures of the skull base

et al. 2013

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Although the inferior petro-occipital vein has been recently used for vascular access to the cavernous sinus, few detailed descriptions of its anatomy are in the literature. We aimed to investigate the morphology and relationships of this vessel. Twelve latex-injected cadaveric heads (24 sides) were dissected to identify the inferior petro-occipital vein and anatomic details documented. The petro-occipital vein was identified on 83.3% of sides. Generally this vein united the internal carotid venous plexus to the superior jugular bulb. However, on 10% of sides, the anterior part of this vein communicated directly with the cavernous sinus, and on 15%, the posterior vein drained into the inferior petrosal sinus at its termination into the superior jugular bulb. The petro-occipital vein was separated from the overlying inferior petrosal sinus by a thin plate of bone. On 40% of sides, small venous connections were found between these two venous structures. The vein was usually larger if a nondominant transverse sinus was present. The overlying inferior petrosal sinus was smaller in diameter when an underlying inferior petro-occipital vein was present. On 20% of sides, the posterior aspect of the vein communicated with the hypoglossal canal veins. On three sides, diploic veins from the clivus drained into the inferior petro-occipital vein. The inferior petro-occipital vein is present in most humans. This primarily extracranial vessel communicates with intracranial venous sinuses and should be considered an emissary vein. Knowledge of this vessel's exact anatomy may be useful to cranial base surgeons and endovascular specialists.

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A new transvenous approach to the carotid-cavernous sinus via the inferior petrooccipital vein

Abstract: 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.

Cited by 24 publications

References 13 publications

Transvenous embolization of cavernous sinus dural arteriovenous fistula through a thrombosed inferior petrosal sinus utilizing 3D venography

Transvenous embolization of cavernous sinus dural arteriovenous fistula through a thrombosed inferior petrosal sinus utilizing 3D venography

Endovascular Approaches to the Carotid Cavernous Sinus for Endovascular Treatment of Carotid Cavernous Fistulas and Hormone Sampling

Anatomy of the inferior petro‐occipital vein and its relation to the base of the skull: Application to surgical and endovascular procedures of the skull base

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