Trans-sphenoidal Approach to the Supraclinoid Internal Carotid Artery for Endovascular Access in a Cadaver

Trans-sphenoidal Approach to the Supraclinoid Internal Carotid Artery for Endovascular Access in a Cadaver

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PurposeSometimes, 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 MethodsIn a fresh cadaver head, the sphenoid sinus was dissected through a Mains Terminal Block 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.ResultsThe 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.ConclusionWhile Drainage Bags 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.