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- Title
Trans-sphenoidal Approach to the Supraclinoid Internal Carotid Artery for Endovascular Access in a Cadaver.
- Authors
Johnson, Andrew Kelly; Holt, Hunter Kegan; Serici, Anthony Joseph; Moftakhar, Roham
- 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.
- Subjects
CRANIAL fontanelles; INTERNAL carotid artery; ENDOVASCULAR surgery; DIGITAL subtraction angiography; DIGITAL angiography
- Publication
Neurointervention, 2013, Vol 8, Issue 1, p29
- ISSN
2093-9043
- Publication type
Article
- DOI
10.5469/neuroint.2013.8.1.29