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Consent for inferior petrosal sinus sampling and administration of - virginia

Consent for inferior petrosal sinus sampling and administration of - virginia 2025

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The document is a consent form for inferior petrosal sinus sampling and anesthesia administration at the University of Virginia Health System. It outlines the procedure, associated risks, potential need for additional procedures, and the involvement of qualified practitioners including residents. The patient acknowledges understanding their diagnosis (Cushing's disease), the risks of surgery and anesthesia, alternatives to the procedure, and consents to the use of any removed tissues for lawful purposes. The form also includes sections for patient signature, physician statement, and interpreter attestation.

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What is venous sampling of inferior petrosal sinus?

Inferior petrosal sinus sampling (IPSS) is an invasive procedure in which adrenocorticotropic hormone (ACTH) levels are sampled from the veins that drain the pituitary gland; these levels are then compared with the ACTH levels in the peripheral blood to determine whether a pituitary tumor (as opposed to an ectopic

Is inferior petrosal sinus sampling safe?

The technique is an invasive but relatively safe method for measuring ACTH in blood samples from the bilateral inferior petrosal sinuses (IPSs) compared to a simultaneous peripheral sample (the IPS/P ratio), and its diagnostic accuracy is much improved by using CRH stimulation.

How is inferior petrosal sinus sampling done?

How do we do an IPSS procedure? Typically under general anesthesia, we place small tubes (catheters) into the femoral veins (the main vein draining the legs) at the level of the groin. From there, under X-ray guidance, we navigate those catheters to the main veins which drain the Pituitary gland.

What are the indications for inferior petrosal sinus sampling?

Indication. Inferior petrosal sinus sampling is most frequently indicated when patients have confirmed ACTH dependent Cushings syndrome. ACTH secreting pituitary microadenomas, which may be inapparent on imaging in 40 to 50% of cases, account for 80% of non-adrenal, non-iatrogenic cases.

Is petrosal sinus sampling painful?

Some patients report feeling a sensation behind their nose and eyes once the catheters are guided through the veins up into the vein near the pituitary gland, and a rushing noise in their ears when X-ray contrast is injected, but most of the time patients do not consider it painful.