부산대학교 도서관

Background: The inferior petrosal sinus (IPS) is the transvenous access route for neurointerventional surgery that is occasionally undetectable on digital subtraction angiography (DSA) because of blockage by a clot or collapse. This study was aimed at analyzing the distance from the jugular bulb (JB) to the IPS–internal jugular vein (IJV) junction and proposing a new anatomical classification system for the IPS–IJV junction to identify the non-visualized IPS orifice. Methods: DSA of 708 IPSs of 375 consecutive patients were retrospectively investigated to calculate the distance from the top of the JB to the IPS–IJV junction, and a simple classification system based on this distance was proposed. Results: The median distance from the top of the JB to the IPS–IJV junction was 20.8 ± 14.7 mm. Based on the lower (10.9 mm) and upper (31.1 mm) quartiles, IPS–IJV junction variants were: type I, 0–10 mm (22.3%); type II, 11–30 mm (45.8%); type III, > 31 mm (23.9%); and type IV, no connection to the IJV (8.0%). Bilateral distances showed a positive interrelationship, with a correlation coefficient of 0.86. The bilateral symmetry type (visualized IPSs bilaterally) according to our classification occurred in 267 of 300 (89.0%) patients. Conclusions: In this study, the IPS–IJV junction was located far from the JB (types II and III), with a higher probability (69.6%). This distance and the four-type classification demonstrated high degrees of homology with the contralateral side. These results would be useful for identifying the non-visualized IPS orifice. [ABSTRACT FROM AUTHOR]