The Analysis of the Petrosal Vein to Prevent Venous Complications During the Anterior Transpetrosal Approach in the Resection of Petroclival Meningioma

Mizutani, Katsuhiro; Toda, Masahiro; Yoshida, Kazunari

doi:10.1016/j.wneu.2016.06.018

Cited by 23 publications

(18 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conversely, one paper [18] reported a predominance of 2 SPVs, but this is likely attributable to their smaller sample. Operative studies are larger but lack detailed anatomical evaluation [15,16,22,25,33,34]. A large non-English operative study found that 2 SPVs was the most prevalent [34].…”

Section: Spvc Anatomymentioning

confidence: 99%

See 1 more Smart Citation

Individual variations of the superior petrosal vein complex and their microsurgical relevance in 50 cases of trigeminal microvascular decompression

2019

View full text Add to dashboard Cite

Background We investigated the understudied anatomical variations of the superior petrosal vein (SPV) complex (SPVC), which may play some role in dictating the individual complication risk following SPVC injury. Methods Microvascular decompressions of the trigeminal nerve between September 2012 and July 2016. All operations utilized an SPVC preserving technique. Preoperative balanced fast field echo (bFFE) magnetic resonance imaging, or equivalent sequences, and operative videos were studied for individual SPVC anatomical features. Results Applied imaging and operative SPVC anatomy were described for fifty patients (mean age, 67.18 years; female sex and right-sided operations, 58% each). An SPVC component was sacrificed intentionally in 6 and unintentionally in only 7 cases. Twenty-nine different individual variations were observed; 80% of SPVCs had either 2 SPVs with 3 or 1 SPV with 2, 3, or 4 direct tributaries. Most SPVCs had 1 SPV (64%) and 2 SPVs (32%). The SPV drainage point into the superior petrosal sinus was predominantly between the internal auditory meatus and Meckel cave (85.7% of cases). The vein of the cerebellopontine fissure was the most frequent direct tributary (86%), followed by the pontotrigeminal vein in 80% of SPVCs. Petrosal-galenic anastomosis was detected in at least 38% of cases. At least 1 SPV in 54% of the cases and at least 1 direct tributary in 90% disturbed the operative field. The tributaries were more commonly sacrificed. Conclusions The extensive anatomical variation of SPVC is depicted. Most SPVCs fall into 4 common general configurations and can usually be preserved. BFFE or equivalent sequences remarkably facilitated the intraoperative understanding of the individual SPVC in most cases.

show abstract

Section: Spvc Anatomymentioning

confidence: 99%

“…There are few data on the frequency of this anastomosis. One study found it in 77.8% of 45 normal subjects using three-dimensional computer tomography venography (3D CTV) [22]. Other cadaveric studies described it in all cases [2,10], the largest study of these had 52 hemispheres (only 26 brains).…”

Section: Individual Spvc Variationsmentioning

confidence: 99%

Individual variations of the superior petrosal vein complex and their microsurgical relevance in 50 cases of trigeminal microvascular decompression

2019

View full text Add to dashboard Cite

show abstract

“…24) Mizutani et al reported that the basal vein via the pontotrigeminal vein serves as a collateral route for the superior petrosal vein in PCM. 25) The risk of sacrificing the superior petrosal veins is well established and can lead to venous complications; 23,26–38) however, there is a very low rate of serious complications related to microvascular decompression (MVD) procedures, in part due to the established practice of coagulating the vein for decompression and/or to achieve better exploration of the nerve. 39) Several authors have reported the importance of preserving venous flow via the petrosal vein during the petrosal approach.…”

Section: Tentorial Groupmentioning

confidence: 99%

“…23,28) In contrast, for the anterior transpetrosal approach, the rate of petrosal vein sacrifice is 25–35.7% and that of postoperative venous complication is 0%. 25,64) According to these results, Mizutani et al suggested that sacrifice of the petrosal vein during the retrosigmoid approach may cause further venous congestion and increase intracerebellar pressure, leading to venous complications. 25) …”

Section: Falcine Groupmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Venous Drainage Patterns for Skull Base Meningioma Surgery

Adachi

Hasegawa

Hirose

2017

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

The evaluation of venous drainage patterns prior to surgery for skull base meningioma is important owing to their deep location and the vulnerability of surrounding vascular structures. In recent years, the microsurgical skull base approach has matured as a surgical technique, making it an important option for reducing complications related to skull base meningioma surgery. In addition, knowledge of the venous anatomy can prevent venous drainage route disturbance and potentially life-threatening complications. Hence, this topic review aimed to provide an overview of normal venous anatomy as it relates to the microsurgical skull base approach, discuss known changes in venous drainage routes that are associated with the progression of skull base meningioma and the selection of an appropriate operative approach with the highest likelihood of preserving venous drainage structures.

show abstract