Direct sampling of the cavernous sinus in Cushing's disease

Sampling of the petrosal sinus is a sensitive and accurate method of diagnosing Cushing's disease. Sampling of the inferior petrosal sinus has been performed with a steam-shaped no. 4 or 5 French soft catheter in some centres. However, a recent report described two patients who suffered major injury to the brain stem as a result such sampling. The authors describe a series of five patients who underwent simultaneous, direct sampling of the cavernous sinuses with a Tracker microcatheter (Target Therapeutics, Fremont, Calif.) for the diagnosis of Cushing's disease. No complications occurred in this small group. The authors conclude that this procedure is a safe and accurate means of diagnosing Cushing's disease; the technique is also helpful in locating adrenocorticotropin-producing microadenoma.