Inferior Petrosal Venous Sinus Sampling

Inferior petrosal sinus sampling is considered the criterion standard for localizing adrenocorticotropic hormone‐producing tumors in patients with Cushing syndrome. Simultaneous, bilateral sampling of the inferior petrosal sinuses is extremely sensitive, specific, safe, and accurate. Anatomic variations are frequently encountered, and a complete understanding of these variants is required to achieve a high procedural success rate. Understanding the indications for inferior petrosal sinus sampling is necessary to identify patients who will benefit from this test. Procedural techniques, accurate sampling, common pitfalls, and interpretation are also reviewed.

Learning Objectives: (1) Identify the indications and contraindications for inferior petrosal sinus sampling, (2) recognize variant inferior petrosal sinus anatomy, and (3) understand procedural techniques, pitfalls, and complications.