Transvenous Embolization of the Basilar Plexus Before Endoscopic Transsphenoidal Transclival Surgery.

Abstract

The endoscopic transclival approach is a method for reaching the anterior side of the brainstem. In making this approach, bleeding from the basilar plexus is often observed when cutting the dura overlying the clivus. Controlling such bleeding is essential. We performed a transvenous embolization of the basilar plexus before making the transclival approach. After embolization, bleeding from the basilar plexus during the operation decreased considerably. To our knowledge, this is the first report of transvenous embolization of the basilar plexus. If the basilar plexus is well developed on preoperative computed tomographic venography or digital subtraction angiography, this procedure is useful for controlling bleeding during endoscopic transclival surgery.