title: An innovative technique for detecting the caudal end of occluded inferior petrosal sinus in cavernous arteriovenous fistula using intravascular ultrasonography--technical note.
abstract: BACKGROUND
  Although cavernous sinus (CS) dural arteriovenous fistulas (d-AVFs) are usually treated with transvenous embolization (TVE) via the inferior petrosal sinus (IPS), IPSs are sometimes thrombosed and angiographically invisible. In such cases, the first obstacle to TVE is detecting the entry to the IPS. We report a new technique for TVE via IPS using intravascular ultrasonography (IVUS).
  
  
  METHODS
  Three consecutive cases of CS d-AVF with ipsilateral or bilateral IPS occlusion were involved in this study. On TVE, the orifice of the IPS was investigated with IVUS placed in the jugular vein or jugular bulb.
  
  
  RESULTS
  This technique has been successfully adapted in all three cases. In two of these cases, IPS was well visualized with the help of IVUS, and TVE was successfully performed.
  
  
  CONCLUSIONS
  To our knowledge, this is the first report to mention the usefulness of IVUS for detecting angiographically occult IPS.
authors.affiliation: Department of Neurosurgery, Hokuto Social Medical Corporation Hokuto Hospital, 7-5 Inada, Obihiro, Hokkaido, 080-0033, Japan, s-yamauchi-bigdipper@trad.ocn.ne.jp.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamauchi
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nishio
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Kimito
authors.initials: K
authors.lastname: Kondo
authors.forename: Taichiro
authors.initials: T
authors.lastname: Kawakami
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Terakawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Mitsuhashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy; D002426:Cavernous Sinus / Q000000981:diagnostic imaging*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000628:therapy