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An Anatomical Study of Skin Entry Locations in Percutaneous Foramen Ovale Cannulation
Author(s) -
Bandak M. Catherine,
Nestor Nicholas,
Zdilla Matthew
Publication year - 2021
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2021.35.s1.04497
Subject(s) - medicine , cannula , percutaneous , patent foramen ovale , foramen ovale (heart) , surgery , anatomy
Patients undergoing percutaneous foramen ovale (FO) cannulation procedures often require additional CT guidance and suffer complications from unsuccessful attempts at puncturing the foramen ovale. Therefore, the aim of this study is to assess the percutaneous entry points for foramen ovale cannulation to decrease procedural risks and improve procedural consistency. Skin entry locations were identified by “reverse” cannulation— transmitting a cannula from target site (intracranially) to the surface of the skin in cadavers. A total of 70 sides were cannulated (26 Male, 44 Female). A cannula was entered through the 1) central porous trigeminus (PT) and central FO, 2) lateral PT and medial FO, and 3) medial PT and lateral FO, for a total of three trajectories. A cannula exit point (i.e., “skin entry point”) was identified by measuring the distance from angle of the mouth. The average lateral and superior‐inferior distance that the cannula exited the skin for the central PT and central FO was 25.4±7.12mm and 2.39 ±11.8mm (mean ± SD), respectively. The average lateral and superior‐inferior distance for the lateral PT and medial FO yielded 13.6 ±5.87mm and 0.128 ± 9.93 mm, respectively. When entered through the medial PT and lateral FO, the cannula was unable to exit the skin due to bony obstruction in 66 out of 70 sides. The results of this study will improve the surgical approach to foramen ovale cannulation.