Journal article
Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results
TheScientificWorld, Vol.2015, 140408
2015
DOI: 10.1155/2015/140408
PMCID: PMC4471318
PMID: 26146651
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.
Details
- Title: Subtitle
- Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results
- Creators
- Robert M Starke - Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22908, USATony Wang - Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22908, USADale Ding - Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22908, USAChristopher R Durst - Department of Radiology, University of Virginia, Charlottesville, VA 22908, USAR. Webster Crowley - Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22908, USA, Department of Radiology, University of Virginia, Charlottesville, VA 22908, USANohra Chalouhi - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA 19107, USADavid M Hasan - Department of Neurological Surgery, University of Iowa, Iowa City, IA 52242, USAAaron S Dumont - Department of Neurological Surgery, Tulane University, New Orleans, LA 70112, USAPascal Jabbour - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA 19107, USAKenneth C Liu - Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22908, USA, Department of Radiology, University of Virginia, Charlottesville, VA 22908, USA
- Resource Type
- Journal article
- Publication Details
- TheScientificWorld, Vol.2015, 140408
- DOI
- 10.1155/2015/140408
- PMID
- 26146651
- PMCID
- PMC4471318
- NLM abbreviation
- ScientificWorldJournal
- ISSN
- 2356-6140
- eISSN
- 1537-744X
- Language
- English
- Date published
- 2015
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040255102771
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