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Petrosal Sinus Sampling Periprocedural Care

  • Author: Gauri Mankekar, MBBS, MS, DNB, PhD; Chief Editor: Jonathan P Miller, MD  more...
 
Updated: Sep 22, 2015
 

Patient Education & Consent

Informed consent is obtained after explaining the possible risks and complications of the procedure.

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Pre-Procedure Planning

Inferior petrosal sinus sampling (IPSS) involves a team of radiology and laboratory technicians to interventional radiologists, endocrinologists, nurses, and anesthetists. Miller and Doppman have emphasized teamwork during the procedure with each member of the team performing their role.[15]

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Equipment

In addition to the microcatheters and other interventional radiology equipment, labeled red Vacutainers, EDTA Vacutainers, syringes, oCRH, hCRH, and heparin for infusion should be kept ready and rechecked prior to the start of the procedure.

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Patient Preparation

If the patient is receiving aspirin, clopidogrel, metyrapone, and/or ketoconazole, these medications should be discontinued at least 5-7 days before the procedure, with prior consent of the physician who prescribed them.

The patient’s coagulation profile, full blood cell count, blood urea, and electrolytes are checked a day prior to the procedure.

The patient’s blood type is checked, and blood is saved in case a blood transfusion is required during the procedure.

The patient should be kept fasting for at least 4 hours prior to the procedure.

The patient’s groin should be shaved and prepared.

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Anesthesia

The patient is given intravenous sedation.

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Positioning

The patient is placed supine.

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Monitoring & Follow-up

The patient is cautioned against moving his or her limbs for a few hours after the procedure and is prescribed analgesics, if required.

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Contributor Information and Disclosures
Author

Gauri Mankekar, MBBS, MS, DNB, PhD Consultant Otorhinolaryngologist, Department of Otolaryngology, PD Hinduja National Hospital, India

Gauri Mankekar, MBBS, MS, DNB, PhD is a member of the following medical societies: Association of Otolaryngologists of India, Cochlear Implant Group of India, Association of Medical Consultants of Mumbai

Disclosure: Nothing to disclose.

Chief Editor

Jonathan P Miller, MD Director, Functional and Restorative Neurosurgery Center, Associate Professor of Neurological Surgery, George R and Constance P Lincoln Endowed Chair, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine

Jonathan P Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Neurological Surgeons, American Medical Association, Congress of Neurological Surgeons, American Society for Stereotactic and Functional Neurosurgery, North American Neuromodulation Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Medtronic Neuromodulation.

Acknowledgements

The authors thank Dr. J. Modhe, Chief, Department of Radiology, PD Hinduja Hospital, Mahim, for reviewing this article.

References
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Inferior Petrosal Sinus Anatomy
IPS variant type 1
IPS variant type 2
IPS variant type 3
IPS variant type 4
 
 
 
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