Endovascular stenting for idiopathic intracranial hypertension with different types of venous sinus stenosis
10.3760/cma.j.cn112138-20210201-00094
- VernacularTitle:特发性高颅压中不同类型静脉窦狭窄的介入治疗
- Author:
Hui SU
1
;
Rongju ZHANG
;
Xiangyu CAO
;
Xinfeng LIU
;
Zhihua DU
;
Baomin LI
;
Jun WANG
Author Information
1. 解放军总医院第一医学中心神经内科，北京 100853
- Keywords:
Intracranial hypertension;
Stents;
Idiopathic intracranial hypertension
- From:
Chinese Journal of Internal Medicine
2021;60(8):728-733
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of endovascular stenting of various types of venous sinus stenosis in idiopathic intracranial hypertension (IIH).Method:Clinical, radiological, and manometric data before and after stenting in venous sinus stenosis were retrospectively analyzed in 99 IIH patients who were refractory to medical therapy or rapidly progressed between July 2004 to July 2019. The follow-up period was between 2.3 months to 11 years.Results:Our study enrolled 21 men (21.2%)and 78 women (78.8%) with average body mass index (BMI) 19.2-40.6(27.0±4.4) kg/m2 and median age 37 years. Before stent placement, the mean transverse sinus stenosis gradient was 1-59(26±8) mmHg. Patients with extrinsic stenosis were younger than those with intrinsic and mixed stenosis. In all cases, stenting was effective for papilledema. Fifty patients complained of headaches. Pulsatile tinnitus in twenty-eight patients completely alleviated after stenting. In one patient, replacement of stent did not improve symptoms, and a subsequent CSF diversion procedure was performed and effective.Conclusion:Irrespective of the type of stenosis, stenting of venous sinus stenosis is an effective treatment for IIH. Patients with persistent papilledema post-stenting and elevated transverse pressure pre-stenting should be followed closely as high risk of stenting failure may occur and further diversion procedure is needed.
