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Treatment / Inferior Petrosal Sinus Sampling

Cushing’s syndrome is excess of the hormone cortisol. It is normally produced by the adrenal gland and, when in excess, can cause a myriad of symptoms. The cause can be a tumor of the adrenal gland or another tumor causing the adrenal gland to produce excess cortisol. Cushing’s Disease is when that tumor is located in the Pituitary gland. Tumors cause the adrenal gland to produce excess cortisol by secreting a hormone called adrenocorticotrophic hormone (ACTH).

The IPSS test is done in some patients to identify if there is too much ACTH is causing the excess production of cortisol, and where it is coming from.

Inferior Petrosal Sinus Sampling

Typically performed under sedation, your physician will place catheters (small tubes) into the femoral veins (the main vein draining the legs) at the level of the groin. Next, under image guidance, the catheters are navigated to the main veins which drain the Pituitary gland. These are the inferior petrosal sinuses (right and left). Then samples are drawn from those veins and the main vein of the abdomen and tested for ACTH. Timed samples are also taken after giving a dose of medication which would normally stimulate the production of ACTH to improve the sensitivity of the test.

When results are provided, the different levels of ACTH may help the endocrinologist determine where the tumor is located that is causing the adrenal gland to produce the excess cortisol. If it is from the Pituitary gland, any difference between the right and left samples may help the surgeon determine the surgical plan to remove the tumor yet preserve the normal Pituitary gland.

Recovery

After the catheters are removed, patients are observed for 2 hours following the procedure ensuring that no bleeding from the femoral vein puncture sites occur.

A blood thinner might be used depending on the patient’s anatomy, medical history and potential to develop a blood clot.

If you are interested in scheduling or learning more about inferior petrosal sinus sampling, call IVC today at 503-612-0498 and schedule an appointment for consultation.

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