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

Publication ,  Journal Article
Starke, RM; Wang, T; Ding, D; Durst, CR; Crowley, RW; Chalouhi, N; Hasan, DM; Dumont, AS; Jabbour, P; Liu, KC
Published in: ScientificWorldJournal
2015

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.

Duke Scholars

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Published In

ScientificWorldJournal

DOI

EISSN

1537-744X

Publication Date

2015

Volume

2015

Start / End Page

140408

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Radiography
  • Pseudotumor Cerebri
  • Postoperative Complications
  • Male
  • Humans
  • General Science & Technology
  • Follow-Up Studies
  • Female
 

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APA
Chicago
ICMJE
MLA
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Starke, R. M., Wang, T., Ding, D., Durst, C. R., Crowley, R. W., Chalouhi, N., … Liu, K. C. (2015). Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results. ScientificWorldJournal, 2015, 140408. https://doi.org/10.1155/2015/140408
Starke, Robert M., Tony Wang, Dale Ding, Christopher R. Durst, R Webster Crowley, Nohra Chalouhi, David M. Hasan, Aaron S. Dumont, Pascal Jabbour, and Kenneth C. Liu. “Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results.ScientificWorldJournal 2015 (2015): 140408. https://doi.org/10.1155/2015/140408.
Starke RM, Wang T, Ding D, Durst CR, Crowley RW, Chalouhi N, et al. Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results. ScientificWorldJournal. 2015;2015:140408.
Starke, Robert M., et al. “Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results.ScientificWorldJournal, vol. 2015, 2015, p. 140408. Pubmed, doi:10.1155/2015/140408.
Starke RM, Wang T, Ding D, Durst CR, Crowley RW, Chalouhi N, Hasan DM, Dumont AS, Jabbour P, Liu KC. Endovascular Treatment of Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: Complications, Neurological Outcomes, and Radiographic Results. ScientificWorldJournal. 2015;2015:140408.

Published In

ScientificWorldJournal

DOI

EISSN

1537-744X

Publication Date

2015

Volume

2015

Start / End Page

140408

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Radiography
  • Pseudotumor Cerebri
  • Postoperative Complications
  • Male
  • Humans
  • General Science & Technology
  • Follow-Up Studies
  • Female