Guidewire Breakage During Cavernous Sinus Sampling: A Rare Complication and Its Treatment

World Neurosurg. 2017 Nov:107:1052.e1-1052.e6. doi: 10.1016/j.wneu.2017.08.102. Epub 2017 Aug 24.

Abstract

Background: Venous sampling methods are valuable tools for the diagnosis of pituitary adenomas. However, these interventions also have complications, which may complicate the treatment process.

Case description: A 49-year-old female pituitary adenoma patient with preliminary diagnosis of Cushing disease underwent cavernous sinus sampling (CSS) to delineate the adenoma. The microguidewire broke during the procedure, and the distal part of the microguidewire had to be left within the right cavernous sinus. Eventually, the broken part of the guidewire was removed after the removal of the tumor through an endoscopic endonasal approach.

Conclusions: Current surgical experience on endoscopic skull base surgery allows management of diagnostic complications related to the cavernous sinus, such as safe access to materials which were inadvertently left during CSS, without the necessity for further interventions.

Keywords: Cavernous sinus sampling; Complication; Cushing disease; Endoscopic endonasal approach; Skull base endoscopy.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / diagnosis
  • Adenoma / surgery
  • Cavernous Sinus / diagnostic imaging*
  • Cavernous Sinus / surgery*
  • Equipment Failure
  • Female
  • Foreign Bodies / diagnostic imaging*
  • Foreign Bodies / surgery*
  • Humans
  • Intraoperative Complications / diagnosis*
  • Intraoperative Complications / surgery*
  • Middle Aged
  • Neuroendoscopy / methods
  • Pituitary ACTH Hypersecretion / diagnosis
  • Pituitary ACTH Hypersecretion / surgery
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / surgery
  • Treatment Outcome