{
  "abstract": "Emerging interest in intravascular brain-computer interfaces has highlighted the need to better understand the feasibility of venous access to eloquent cortical regions. This study evaluates the anatomical constraints of the cerebral venous system for potential catheter-based access to the motor cortex.145 patients scanned from 2015-2025 with a GE Healthcare SIGNA Artist 1.5 T scanner, who had both MRI and contrast-enhanced MRV scans of the brain within 24 hours of each other, were reviewed retrospectively. T1 MRI sequences were analyzed using FreeSurfer (an open-source neuroimaging software package) to identify the precentral cortex, including the motor hand knob region as the target for trajectory analysis. MRV was rigidly registered to the T1 MRI using Advanced Normalization Tools (ANTs). Cortical veins were segmented from the co-registered MRV using a Frangi vesselness filter to enhance tubular vascular structures. The distance between cortical veins and anatomical landmarks, such as the precentral motor hand knob region, was measured using a Euclidean distance transform. Dijkstra-based pathfinding was used to simulate venous catheterization trajectories connecting the internal jugular veins to the ipsilateral and contralateral hand knob regions via the transverse, sigmoid, and superior sagittal sinuses (SSS).Following analysis, 24 patients had pathology that would directly affect cortical vein anatomy and were excluded from the analysis. Of the 121 patients remaining, 19 patients had imaging features concerning for idiopathic intracranial hypertension (IIH), and an additional 19 had unilateral or bilateral transverse or sigmoid sinus abnormalities. Overall, 83 percent of patients demonstrated a feasible simulated catheterization trajectory reaching within 5 mm of the cortical surface of the hand knob region, with the entire pathway maintaining a diameter greater than 2 mm. Furthermore, the approximate bend along the simulated catheter pathway at the SSS-cortical vein interface was 149 degrees and 140 degrees for the left and right hand knob regions, respectively.These findings suggest that endovascular access to the motor cortex via cortical venous pathways is anatomically feasible in a majority of patients. Such characterization of venous anatomy and trajectory constraints may inform the development and deployment of intravascular neural interface technologies in the future.Disclosures A. Feizi: None. N. Valizadeh: None. A. Mohseny: None. N. Naidich: None. P. Reddi: None. B. Delman: None. S. Majidi: None.Abstract O-053 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Mount Sinai Hospital, New York, NY"
      ],
      "name": "A Feizi"
    },
    {
      "affiliations": [
        "Mount Sinai Hospital, New York, NY"
      ],
      "name": "N Valizadeh"
    },
    {
      "affiliations": [
        "Mount Sinai Hospital, New York, NY"
      ],
      "name": "A Mohseny"
    },
    {
      "affiliations": [
        "Mount Sinai Hospital, New York, NY"
      ],
      "name": "N Naidich"
    },
    {
      "affiliations": [
        "Mount Sinai Hospital, New York, NY"
      ],
      "name": "P Reddi"
    },
    {
      "affiliations": [
        "Mount Sinai Hospital, New York, NY"
      ],
      "name": "B Delman"
    },
    {
      "affiliations": [
        "Mount Sinai Hospital, New York, NY"
      ],
      "name": "S Majidi"
    }
  ],
  "title": "O-053 Planning intravascular brain-computer interfaces: constraints of cerebral venous anatomy",
  "uid": "a00ac53b-64d9-52b8-8677-f3558540226e"
}