Curative effect observation of venous sinus stenting in treatment of venous sinus stenosis in idiopathic intracranial hypertension
10.3760/cma.j.issn.1005?1201.2017.11.007
- VernacularTitle:静脉窦支架成形术治疗特发性颅高压综合征合并静脉窦狭窄的有效性和安全性
- Author:
Ying WEI
1
;
Xinbin GUO
;
Sheng GUAN
;
Zibo WANG
;
Xin DENG
;
Xiaoke LU
Author Information
1. 450052,郑州大学第一附属医院神经介入科
- Keywords:
Intracranial hypertension;
Stents;
Radiology;
interventional;
Venous sinus stenosis
- From:
Chinese Journal of Radiology
2017;51(11):848-851
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy and safety of venous sinus stenting in the treatment of refractory idiopathic intracranial hypertension (IIH) complicated with venous sinus stenosis. Methods We reviewed our clinical database for 18 patients with resistant or fulminant IIH and cerebral venous sinus stenosis,who underwent placement of venous sinus stents between January 2013 and December 2016. Patients were considered eligible for stenting based on the following criteria: (1) medically refractory IIH;(2)papilledema confirmed by an ophthalmologist;and(3)dural venous sinus stenosis of the dominant venous outflow system with a gradient of ≥10 mmHg(1 mmHg=0.133 kPa). Prior to intervention, diagnostic angiography and venous pressure measurements were performed. Clinical follow-up was available in all patients at 6 to 48 months after stenting.Angiography to evaluate stent patency and restenosis was performed at 6 months after intervention;Relevant clinical, demographic and radiographic data were extracted after review of these records. The paired t test was used to compare the changes before and after the operation. Results The mean lumbar CSF pressure was reduced from (385±72) mmH2O(1 mmH2O=0.009 8 kPa) to (201±24)mmH2O(t=13.02,P<0.05).The mean pressure gradient across the venous stenosis was reduced from(31.5±11.4)mmHg before the procedure to(2.5±2.1)mmHg(t=10.96,P<0.05).Headache in 13 cases,vision in 14 were resolved. Papilledema and pulsatile tinnitus resolved in all patients. There was no instances of restenosis among the 18 patients with follow-up imaging.Conclusion In patients with IIH and documented evidence of venous sinus stenosis with a high pressure gradient,venous sinus senting represents an effective treatment strategy.
