Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results.

Authors

• Robert M Starke
• Tony Wang
• Dale Ding
• Christopher R Durst
• R Webster Crowley
• Nohra Chalouhi
• David M Hasan
• Aaron S Dumont
• Pascal Jabbour
• Kenneth C Liu

Publication/Presentation Date

1-1-2015

Abstract

INTRODUCTION: Idiopathic intracranial hypertension (IIH) may result in a chronic debilitating disease. Dural venous sinus stenosis with a physiologic venous pressure gradient has been identified as a potential etiology in a number of IIH patients. Intracranial venous stenting has emerged as a potential treatment alternative.

METHODS: A systematic review was carried out to identify studies employing venous stenting for IIH.

RESULTS: From 2002 to 2014, 17 studies comprising 185 patients who underwent 221 stenting procedures were reported. Mean prestent pressure gradient was 20.1 mmHg (95% CI 19.4-20.7 mmHg) with a mean poststent gradient of 4.4 mmHg (95% CI 3.5-5.2 mmHg). Complications occurred in 10 patients (5.4%; 95% CI 4.7-5.4%) but were major in only 3 (1.6%). At a mean clinical follow-up of 22 months, clinical improvement was noted in 130 of 166 patients with headaches (78.3%; 95% CI 75.8-80.8%), 84 of 89 patients with papilledema (94.4%; 95% CI 92.1-96.6%), and 64 of 74 patients with visual symptoms (86.5%; 95% CI 83.0-89.9%). In-stent stenosis was noted in six patients (3.4%; 95% CI 2.5-4.3%) and stent-adjacent stenosis occurred in 19 patients (11.4%; 95% CI 10.4-12.4), resulting in restenting in 10 patients.

CONCLUSION: In IIH patients with venous sinus stenosis and a physiologic pressure gradient, venous stenting appears to be a safe and effective therapeutic option. Further studies are necessary to determine the long-term outcomes and the optimal management of medically refractory IIH.

Volume

2015

First Page

140408

Last Page

140408

ISSN

1537-744X

Published In/Presented At

Starke, R. M., Wang, T., Ding, D., Durst, C. R., Crowley, R. W., Chalouhi, N., Hasan, D. M., Dumont, A. S., Jabbour, P., & Liu, K. C. (2015). Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results. TheScientificWorldJournal, 2015, 140408. https://doi.org/10.1155/2015/140408

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

26146651

Department(s)

Administration and Leadership

Document Type

Article