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Venous sinus manometry and intervention using the PrimeWire Prestige pressure guidewire: technique and initial experience
  1. Demetrius Klee Lopes,
  2. Andrew Kelly Johnson,
  3. Lee A Tan
  1. Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA
  1. Correspondence to Dr D K Lopes, Department of Neurosurgery, Rush University Medical Center, 1725 W. Harrison St, Suite 1115, Chicago, IL 60612, USA; brainaneurysm{at}mac.com

Abstract

Background Cerebral venography and manometry are used for the diagnosis of hemodynamically significant venous sinus stenosis in patients with the syndrome of idiopathic intracranial hypertension. Intravenous pressure measurements using the traditional microcatheter technique can be cumbersome, time consuming and potentially unreliable. The PrimeWire Prestige pressure guidewire conducts pressure electrically and can be used as a guidewire for intervention. It has been validated in interventional cardiology procedures.

Objective We describe our initial clinical experience with the PrimeWire Prestige pressure guidewire system for cerebral venous manometry and intervention.

Method Cerebral venous pressure gradient was directly measured by advancing the pressure wire across a region of stenosis. The pressure wire was also used as a guidewire for intravascular ultrasound, angioplasty and stenting.

Results The PrimeWire Prestige pressure guidewire successfully navigated the intracranial venous sinus anatomy. Transfer of devices over the guidewire in a monorail fashion was uncomplicated, and measurement of sinus pressure between the steps of the intervention was efficiently performed.

Conclusion The PrimeWire Prestige pressure guidewire system provided a safe, fast and effective method for intracranial venous sinus manometry and intervention. It has several potential advantages over the traditional microcatheter method, including efficiency, accuracy and cost.

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