Trans-sphenoidal Approach to the Supraclinoid Internal Carotid Artery for Endovascular Access in a Cadaver.
10.5469/neuroint.2013.8.1.29
- Author:
Andrew Kelly JOHNSON
1
;
Hunter Kegan HOLT
;
Anthony Joseph SERICI
;
Roham MOFTAKHAR
Author Information
1. Department of Neurological Surgery, Rush University Medical Center, Chicago, IL, USA. andrew_johnson@rush.edu
- Publication Type:Original Article
- Keywords:
Trans-sphenoid;
Endovascular;
Internal carotid artery
- MeSH:
Angiography, Digital Subtraction;
Arteries;
Cadaver;
Carotid Arteries;
Carotid Artery, Internal;
Catheters;
Endovascular Procedures;
Head;
Sphenoid Sinus
- From:Neurointervention
2013;8(1):29-33
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Sometimes, intracranial pathology in the distal vasculature cannot be accessed by standard endovascular techniques because of occlusion or insurmountable tortuosity of theinternal carotid artery (ICA). A trans-sphenoidal surgical approach can follow a similar trajectory to the course of the supraclinoid ICA. This study evaluates the feasibility of a trans-sphenoidal approach to the supraclinoid ICA for endovascular access. MATERIALS AND METHODS: In a fresh cadaver head, the sphenoid sinus was dissected through a trans-sphenoidal route. Bone over the carotid prominence was removed to expose the ICA. The artery was catheterized using the Seldinger technique, and three-dimensional digital subtraction angiography was performed to evaluate the procedure. RESULTS: The catheter was successfully inserted into the supraclinoid ICA via the trans-sphenoidal route. Three-dimensional radiographic reconstruction confirmed placement of the catheter and the trajectory of the sheath into the supraclinoid ICA. CONCLUSION: While the trans-sphenoidal route has innumerable disadvantages over the standard endovascular access techniques, this route could be considered when other treatment options are too risky or impractical.
