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Percutaneous Biopsy of Firm Cavernous Sinus Lesions

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This short video refers to the technique for percutaneous biopsy of firm cavernous sinus lesions. Please refer to the accompanying chapter and paper regarding this specific details. This is a 55 year old male who presented with right side facial numbness and pain, and was diagnosed with a large firm right-sided cavernous sinus mass. The initial technique of aspiration through the needle did not allo any tissue to be obtained within the syringe, and therefore this alternative technique was used after the foramen ovale was accessed via the Tru-cut liver biopsy needle. The stylet of the needle was removed and a K-wire was passed through the needle into the area of the lesion via lateral fluoroscopy. Here's the needle is removed. The Tru-cut liver biopsy needle was removed and the Angiocath catheter was passed and threaded over the K-wire into the area of the lesion. The skin around the area of the entry point was kept taught so that the Angiocath can be advanced. Next, the K-wire was removed and the stylet of Angiocath was also removed and endoscopic tissue grabbers were used to biopsy the lesion and obtain generous pieces of specimen. You can see that the grabber was marked with Steri-Strips to make sure that it can not be advanced too far beyond the tip of the Angiocath. Thank you.

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