Rational sacrifice of the superior petrosal vein

•We propose that the safety of SPV sacrifice depends on whether there are collaterals to the SPV.•Hence, the risk of SPV sacrifice may be assessed by evaluation of the presence of collaterals to the SPV.•Indirect evaluation may be achieved by observing the size of the SPV on preoperative 3D-MRA, DSA...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2023-09, Vol.115, p.136-137
Main Author: Zheng, Yilong
Format: Article
Language:English
Subjects:
Preservation
Sacrifice
Superior petrosal vein
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Summary:•We propose that the safety of SPV sacrifice depends on whether there are collaterals to the SPV.•Hence, the risk of SPV sacrifice may be assessed by evaluation of the presence of collaterals to the SPV.•Indirect evaluation may be achieved by observing the size of the SPV on preoperative 3D-MRA, DSA, or intraoperative inspection.•Direct evaluation may be achieved by looking for collaterals on preoperative 3D-MRA, DSA, or intraoperative inspection with ICG confirmation. During surgeries of the posterior cranial fossa, sacrificing the superior petrosal vein (SPV) can enhance visualization of the operative field but may also lead to postoperative venous infarction with potentially fatal consequences. We previously proposed that the safety of SPV sacrifice depends on whether there are collaterals that can take on the venous flow of the SPV after its sacrifice. Here, we propose several practical strategies that may be able to evaluate the presence of collaterals to the SPV, so that the safety of SPV sacrifice can be assessed.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2023.08.004