Is inferior petrosal sinus sampling safe?

Background and purpose: Inferior petrosal sinus sampling (IPSS) is a useful diagnostic technique in adrenocorticotropic hormone (ACTH)-dependent hypercortisolism with normal or equivocal MR imaging. The procedure is believed to be safe, with mostly minor complications.

Is petrosal sinus sampling painful?

Petrosal sinus sampling is an invasive procedure where blood samples are taken from each side of the veins that drain into the pituitary gland. Although the procedure is not painful, you may experience minor pain when the catheter (tubing) is passed through the veins.

How is IPSS done?

How do we do an IPSS procedure? Typically under general anesthesia, we place small tubes (catheters) into the femoral veins (the main vein draining the legs) at the level of the groin. From there, under X-ray guidance, we navigate those catheters to the main veins which drain the Pituitary gland.

What is petrosal sinus sampling?

Inferior petrosal sinus sampling (IPSS) is an invasive procedure in which adrenocorticotropic hormone (ACTH) levels are sampled from the veins that drain the pituitary gland; these levels are then compared with the ACTH levels in the peripheral blood to determine whether a pituitary tumor (as opposed to an ectopic …

Where is the inferior petrosal sinus?

The inferior petrosal sinus (sinus petrosus inferior) is situated in the inferior petrosal sulcus formed by the junction of the petrous part of the temporal with the basilar part of the occipital.

What are the symptoms of pituitary gland disorders?

What are pituitary symptoms?

• Headaches.
• Vision problems.
• Unexplained weight gain.
• Loss of libido.
• Feeling dizzy and nauseous.
• Pale complexion.
• Muscle wasting.
• Coarsening of facial features.

What is the meaning of Petrosal?

: of, relating to, or situated in the region of the petrous portion of the temporal bone or capsule of the inner ear.

What is the purpose of inferior petrosal sinus sampling?

Inferior Petrosal Sinus Sampling. Inferior petrosal sinus sampling is a procedure that may be required to confirm the source of ACTH-dependent Cushing’s syndrome. Lab studies can often differentiate ectopic from pituitary ACTH-driven Cushing’s syndrome, but it is clear that the levels, even on dynamic testing, may have some overlap.

Which is the most accurate petrosal sinus test?

Bilateral simultaneous sampling of the inferior petrosal sinuses is an extremely sensitive, specific, and accurate test for diagnosing Cushing disease and distinguishing between that entity and the ectopic ACTH syndrome. It is also valuable for lateralizing small hormone-producing adenomas within the pituitary gland.

How are ACTH values obtained from the inferior petrosal sinus?

The technique is performed by cannulation of the bilateral femoral veins, and advancing catheters into the inferior petrosal sinuses via the internal jugular veins. Baseline ACTH values are obtained from the periphery and the inferior petrosal sinuses both before and after CRH stimulation (1 μg/kg of body weight).

How is the inferior petrosal sinus connected to the jugular vein?

The inferior petrosal sinuses connect the cavernous sinuses with the ipsilateral internal jugular veins. The anatomy of the anastomoses between the inferior petrosal sinus, the internal jugular vein, and the venous plexuses at the base of the skull varies, but it is almost always possible to catheterize the inferior petrosal sinus.