Figure 3.

Illustrative depiction of the use of the anchoring technique in conjunction with the Cobra technique to achieve distal venous sinus access. On the left is a roadmap of the right superior sagittal, transverse, sigmoid, and jugular sinuses. To achieve distal access, the guide catheter balloon can be inflated at the transverse sigmoid junction to anchor it against the sinus walls. The balloon is outlined with a dotted line. A smaller monorail balloon can then be sub-maximally inflated over a microwire at the tip of the intermediate catheter to decrease the ledge effect and allow for smoother distal navigation of the intermediate catheter distally into the SSS. On the right is a corresponding graphical depiction with the BGC depicted within the transverse sinus, the intermediate catheter in the SSS, the balloon catheter and microwire in the SSS.