[Technical and functional aspects of catheterization of inferior petrosal sinuses in ACTH dependent Cushing's syndrome].
OBJECTIVE
To describe and analyze technique for bilateral catheterization of inferior petrosal sinus in our service, discussing the difficulties and success rates found.


METHODS
Fourteen patients with suspected Cushing's syndrome underwent bilateral inferior petrosal sinuses (IPS) catheterization between 2009 and 2012. The technique for catheterization and for hormone analysis were described.


RESULTS
The procedure was well tolerated by all patients, and adequate catheterization was achieved in 92.85% of cases. The diagnosis of Cushing's disease was confirmed in 10 cases. The result of IPS catheterization after CRH infusion was coherent in all cases, without false negatives.


CONCLUSIONS
The catheterization of IPS, despite being an invasive technique, is a safe procedure. The objectives can be done properly in most cases. When well indicated, this procedure remains the gold standard in distinguishing the ectopic form to pituitary source in Cushing's syndrome.
Departamento de Neurocirurgia, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
João Miguel de Almeida
JM
Silva
Departamento de Neurocirurgia, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Guilherme Brasileiro de
GB
Aguiar
Departamento de Neurocirurgia, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Mario Luiz Marques
ML
Conti
Departamento de Neurocirurgia, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Américo Rubens Leite dos
AR
Santos
Departamento de Endocrinologia, ISCMSP, São Paulo, SP, Brasil.
José Viana
JV
Lima Junior
Departamento de Neurocirurgia, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
José Carlos Esteves
JC
Veiga
D000182:ACTH Syndrome, Ectopic / Q000175:diagnosis; D000236:Adenoma / Q000175:diagnosis; D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D002405:Catheterization, Central Venous / Q000379:methods*; D002648:Child; D003480:Cushing Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017591:Petrosal Sinus Sampling / Q000379:methods*; D010911:Pituitary Neoplasms / Q000175:diagnosis; D011388:Prolactin / Q000097:blood
D000324:Adrenocorticotropic Hormone; D011388:Prolactin