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A Transvenous Endovascular Approach in Straight Sinus has Minor Impacts on Chordae Willisii

Yuanliang Ye1, Jiuyang Ding2, Shoutang Liu3

  • 1Department of Neurosurgery, Liuzhou People's Hospital, Liuzhou, Guangxi Autonomous Region; Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

Neurology India
|September 9, 2022
PubMed

Insights

Transvenous endovascular procedures may cause minor damage to the chordae willisii (CW) in the straight sinus, particularly with stent use. Repeated navigation did not increase CW damage risk.

Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Medical Device Technology

Background:

  • Transvenous endovascular approaches are standard for cerebrovascular diseases.
  • Potential iatrogenic damage to chordae willisii (CW) in the straight sinus is a concern.
  • Limited literature addresses CW damage during these procedures.

Purpose of the Study:

  • Investigate potential damage to CW in the straight sinus during transvenous endovascular procedures.
  • Assess the impact of endovascular devices on CW integrity.

Main Methods:

  • Endoscopic observation of CW features in 38 cadaveric heads.
  • Mimicking mechanical thrombectomy procedures in the straight sinus.
  • Light microscopy to evaluate CW damage post-procedure.

Main Results:

  • Valve-like and longitudinal lamellae were observed, predominantly posteriorly.
  • Trabeculae were present in both anterior and posterior straight sinus.
  • Stent use showed a significantly higher rate of Grade 1 CW damage (P=0.02) and surface damage (P=0.00) compared to balloons.
  • Repeated procedures with stents or balloons did not increase CW damage rates.

Conclusions:

  • Stent and balloon navigation in the straight sinus can inflict minor CW damage.
  • Retrograde navigation does not appear to elevate the risk of CW damage.
Abstract

Keywords:
Chordae willisiiendoscopyinterventionstraight sinusvenous sinus thrombosis

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