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.

How long does an IPSS test take?

You will be given an intravenous injection of corticotropin releasing hormone (CRH). Once you have had the CRH injection, a series of blood samples will be taken over a period of 10 minutes.

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 to obtain informed consent for petrosal sinus sampling?

Informed consent is obtained after explaining the possible risks and complications of the procedure. Inferior petrosal sinus sampling (IPSS) involves a team of radiology and laboratory technicians to interventional radiologists, endocrinologists, nurses, and anesthetists.

Is it possible to catheterize both inferior petrosal sinuses?

When the procedure is performed as outlined, both inferior petrosal sinuses can be catheterized in more than 98% of patients. The complication rate is low, and the theoretical risk of major morbidity or death is less than 1% (neither has yet occurred, to our knowledge).