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Venous sinus stenting in patients without idiopathic intracranial hypertension.
J Neurointerv Surg. 2017 May; 9(5):512-515.JN

Abstract

BACKGROUND

Venous sinus stenting is an effective treatment for patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis.

OBJECTIVE

To determine the usefulness of venous sinus stenting in the treatment of patients with symptomatic venous sinus stenosis without a diagnosis of IIH.

METHODS

We performed a retrospective review of a prospective multicenter database of patients undergoing venous sinus stenting between January 2008 and February 2016. Patients with acute dural venous sinus thrombosis, arteriovenous fistula or arteriovenous malformation, or IIH were excluded. Clinical, radiological, and ophthalmological information was recorded.

RESULTS

Nine patients met the inclusion criteria and underwent venous sinus stenting for symptomatic dural venous sinus stenosis. Reasons for treatment included isolated unilateral pulsatile tinnitus (n=1), congenital hydrocephalus (n=2), unilateral pulsatile tinnitus following prior venous sinus thrombosis (n=1), acquired hydrocephalus following dural sinus thrombosis (n=2), meningitis (n=2) and tumor invasion into the dural venous sinus (n=1). Six patients underwent lumbar puncture or shunt tap, and all of these patients had elevated intracranial pressure. All stenoses were located in the transverse sinus, transverse-sigmoid junction and/or jugular bulb, and all were treated with self-expanding bare-metal stents. At follow-up, clinical symptoms had resolved in all but two patients, both of whom had congenital hydrocephalus and pre-existing shunts. There was no significant in-stent stenosis, and patients with ophthalmological follow-up demonstrated improvement of papilledema.

CONCLUSIONS

Dural venous sinus stenting may be an effective treatment for patients with symptomatic venous sinus stenosis without IIH in carefully selected cases, but may not be effective in resolving the symptoms of congenital hydrocephalus.

Authors+Show Affiliations

Department of Neurological Surgery, University of Washington, Seattle, Washington, USA. Department of Radiology, University of Washington, Seattle, Washington, USA. Department of Mechanical Engineering, University of Washington, Seattle, Washington, USA.Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

27199383

Citation

Levitt, Michael R., et al. "Venous Sinus Stenting in Patients Without Idiopathic Intracranial Hypertension." Journal of Neurointerventional Surgery, vol. 9, no. 5, 2017, pp. 512-515.
Levitt MR, Albuquerque FC, Gross BA, et al. Venous sinus stenting in patients without idiopathic intracranial hypertension. J Neurointerv Surg. 2017;9(5):512-515.
Levitt, M. R., Albuquerque, F. C., Gross, B. A., Moon, K., Jadhav, A. P., Ducruet, A. F., & Crowley, R. W. (2017). Venous sinus stenting in patients without idiopathic intracranial hypertension. Journal of Neurointerventional Surgery, 9(5), 512-515. https://doi.org/10.1136/neurintsurg-2016-012405
Levitt MR, et al. Venous Sinus Stenting in Patients Without Idiopathic Intracranial Hypertension. J Neurointerv Surg. 2017;9(5):512-515. PubMed PMID: 27199383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Venous sinus stenting in patients without idiopathic intracranial hypertension. AU - Levitt,Michael R, AU - Albuquerque,Felipe C, AU - Gross,Bradley A, AU - Moon,Karam, AU - Jadhav,Ashutosh P, AU - Ducruet,Andrew F, AU - Crowley,R Webster, Y1 - 2016/05/19/ PY - 2016/03/23/received PY - 2016/04/12/revised PY - 2016/04/29/accepted PY - 2016/5/21/pubmed PY - 2017/5/27/medline PY - 2016/5/21/entrez KW - Hydrocephalus KW - Intracranial Pressure KW - Stenosis KW - Stent KW - Vein SP - 512 EP - 515 JF - Journal of neurointerventional surgery JO - J Neurointerv Surg VL - 9 IS - 5 N2 - BACKGROUND: Venous sinus stenting is an effective treatment for patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis. OBJECTIVE: To determine the usefulness of venous sinus stenting in the treatment of patients with symptomatic venous sinus stenosis without a diagnosis of IIH. METHODS: We performed a retrospective review of a prospective multicenter database of patients undergoing venous sinus stenting between January 2008 and February 2016. Patients with acute dural venous sinus thrombosis, arteriovenous fistula or arteriovenous malformation, or IIH were excluded. Clinical, radiological, and ophthalmological information was recorded. RESULTS: Nine patients met the inclusion criteria and underwent venous sinus stenting for symptomatic dural venous sinus stenosis. Reasons for treatment included isolated unilateral pulsatile tinnitus (n=1), congenital hydrocephalus (n=2), unilateral pulsatile tinnitus following prior venous sinus thrombosis (n=1), acquired hydrocephalus following dural sinus thrombosis (n=2), meningitis (n=2) and tumor invasion into the dural venous sinus (n=1). Six patients underwent lumbar puncture or shunt tap, and all of these patients had elevated intracranial pressure. All stenoses were located in the transverse sinus, transverse-sigmoid junction and/or jugular bulb, and all were treated with self-expanding bare-metal stents. At follow-up, clinical symptoms had resolved in all but two patients, both of whom had congenital hydrocephalus and pre-existing shunts. There was no significant in-stent stenosis, and patients with ophthalmological follow-up demonstrated improvement of papilledema. CONCLUSIONS: Dural venous sinus stenting may be an effective treatment for patients with symptomatic venous sinus stenosis without IIH in carefully selected cases, but may not be effective in resolving the symptoms of congenital hydrocephalus. SN - 1759-8486 UR - https://www.unboundmedicine.com/medline/citation/27199383/Venous_sinus_stenting_in_patients_without_idiopathic_intracranial_hypertension_ L2 - https://jnis.bmj.com/cgi/pmidlookup?view=long&pmid=27199383 DB - PRIME DP - Unbound Medicine ER -