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Chordae Willisii Within the Transverse Sinus: Morphologic Study
Joe Iwanaga1, Evan Courville2, Mahindra Kumar Anand3
1Department of Neurosurgery and Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan.
Insights
Chordae Willisii, or trabeculae, are common in transverse sinuses, particularly on the right side. Understanding their anatomy is crucial for interpreting imaging and performing endovascular procedures.
Area of Science:
- Neuroanatomy
- Vascular Anatomy
- Medical Imaging
Background:
- Trabeculae within transverse sinuses, known as chordae Willisii, may influence blood flow and thrombus organization.
- These structures are increasingly visualized with modern imaging and encountered during endovascular procedures.
Purpose of the Study:
- To conduct a detailed morphologic study of chordae Willisii within the transverse sinus using cadavers.
- To address the scarcity of comprehensive anatomic data on these intraluminal structures.
Main Methods:
- Dissection of thirty fresh-frozen cadaveric transverse sinuses.
- Recording detailed morphology and applying classification schemes based on anatomy and orientation.
Main Results:
- Chordae Willisii were identified in 70% of dissected sides, with a higher prevalence on the right (86.6%).
- Three distinct types and three classes of chordae were identified.
- A statistically significant difference in chordae type was observed between sides (P = 0.02).
Conclusions:
- A comprehensive anatomic evaluation of transverse sinus chordae Willisii has been lacking.
- This knowledge is essential for interpreting neuroimaging and for safe navigation during endovascular procedures in the dural venous sinuses.
Objective:
Some have suggested that trabeculae within the transverse sinuses (chordae Willisii) might restrict flow and potentially contribute to thrombus organization. In addition, these structures might be encountered with endovascular procedures within the transverse sinus and are now readily seen on imaging. Therefore as anatomic studies of these structures are scant, the current study aimed to better elucidate these structures within the transverse sinus via a morphologic study in cadavers.
Methods:
Thirty fresh-frozen, cadaveric transverse sinuses were dissected, and their detailed morphology was recorded. Classification schemes were applied based on the anatomy and orientation of each chordae.
Results:
Chordae were found on 70% of sides and were statistically more likely to be found on right sides (86.6%) (P < 0.01). Three types and 3 classes of chordae were identified. There was a statistically significant difference between sides regarding type of chordae (P = 0.02).
Conclusions:
To date, a comprehensive anatomic evaluation of the intraluminal chordae of the transverse sinuses has been lacking. Knowledge of these bands is also essential to those performing endovascular procedures of the dural venous sinuses and for those interpreting imaging of these structures.
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