Abstract
Inferior petrosal sinus sampling (IPSS) is an important technique for localizing the source of excess adrenocorticotropic hormone in patients with Cushing syndrome. 1 Super-selective cavernous sinus sampling (CSS) with microvenography is advocated by some operators to enhance the specificity of localization and lateralization.2,3 Despite advances in high-resolution magnetic resonance imaging (MRI) with dynamic contrast enhancement, many patients with equivocal neuroimaging require sampling for definitive diagnosis and pre-operative planning. 4 This operative video presents the technical aspects of performing a ‘hybrid’ IPSS/CSS procedure with pituitary stimulation reflecting the standard practice at a high-volume center. Procedural indications, rationale, and methods for complication avoidance are discussed in depth. Special emphasis is placed on meticulous data acquisition and interpreting the results from a neuroangiographer's perspective.
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Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
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