Tags

Type your tag names separated by a space and hit enter

Endovascular Treatment for Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: An Observational Study of Clinical Indications, Surgical Technique, and Long-Term Outcomes.
World Neurosurg. 2019 Jan; 121:e165-e171.WN

Abstract

BACKGROUND

Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure. IIH causes significant morbidity marked by incapacitating headaches and visual disturbances. This study investigated the long-term outcomes of venous sinus stenting in a large group of patients with IIH.

METHODS

We retrospectively reviewed all patients at our institution who underwent venous sinus stenting for IIH over 6 years (July 1, 2012-June 30, 2018). A particular focus was dedicated to collecting demographic, clinical, radiologic, and outcomes data. All patients had failed medical management.

RESULTS

Of the 110 patients evaluated for IIH, 42 underwent venous sinus stenting, with a mean follow-up of 25.6 months (range, 8.7-60.7 months). The mean age was 32 years (range, 15-52 years), 38 (90%) were women, and the mean body mass index was 35.6 kg/m2 (range, 18.6-47.5 kg/m2). Prior to the stenting procedure, all patients had headaches, visual disturbances, and papilledema. Of the 39 patients who had an ophthalmologic evaluation poststenting, 29 (74%) had resolution of their papilledema. Eighteen patients (43%) had complete resolution of their headaches after the stenting procedure, whereas 22 patients (52%) remained under a neurologist's care for chronic migraine and other types of headaches. Two patients underwent a restenting procedure for disease progression, and 1 patient experienced an in-stent thrombosis.

CONCLUSIONS

A multidisciplinary approach involving neurosurgeons, ophthalmologists, radiologists, and neurologists is integral in the management of patients with IIH to prevent the complications of papilledema. Venous sinus stenting offers a safe and effective means of treating IIH.

Authors+Show Affiliations

Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA.Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA; Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA.Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA.Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA.Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA.Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA. Electronic address: Shervin.Dashti@nortonhealthcare.org.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

30248468

Citation

Shields, Lisa B E., et al. "Endovascular Treatment for Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: an Observational Study of Clinical Indications, Surgical Technique, and Long-Term Outcomes." World Neurosurgery, vol. 121, 2019, pp. e165-e171.
Shields LBE, Shields CB, Yao TL, et al. Endovascular Treatment for Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: An Observational Study of Clinical Indications, Surgical Technique, and Long-Term Outcomes. World Neurosurg. 2019;121:e165-e171.
Shields, L. B. E., Shields, C. B., Yao, T. L., Plato, B. M., Zhang, Y. P., & Dashti, S. R. (2019). Endovascular Treatment for Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: An Observational Study of Clinical Indications, Surgical Technique, and Long-Term Outcomes. World Neurosurgery, 121, e165-e171. https://doi.org/10.1016/j.wneu.2018.09.070
Shields LBE, et al. Endovascular Treatment for Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: an Observational Study of Clinical Indications, Surgical Technique, and Long-Term Outcomes. World Neurosurg. 2019;121:e165-e171. PubMed PMID: 30248468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endovascular Treatment for Venous Sinus Stenosis in Idiopathic Intracranial Hypertension: An Observational Study of Clinical Indications, Surgical Technique, and Long-Term Outcomes. AU - Shields,Lisa B E, AU - Shields,Christopher B, AU - Yao,Tom L, AU - Plato,Brian M, AU - Zhang,Yi Ping, AU - Dashti,Shervin R, Y1 - 2018/09/21/ PY - 2018/08/01/received PY - 2018/09/08/revised PY - 2018/09/11/accepted PY - 2018/9/25/pubmed PY - 2019/1/3/medline PY - 2018/9/25/entrez KW - Endovascular KW - Idiopathic intracranial hypertension KW - Neurosurgery KW - Pseudotumor cerebri KW - Stent KW - Venous sinus stenosis SP - e165 EP - e171 JF - World neurosurgery JO - World Neurosurg VL - 121 N2 - BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure. IIH causes significant morbidity marked by incapacitating headaches and visual disturbances. This study investigated the long-term outcomes of venous sinus stenting in a large group of patients with IIH. METHODS: We retrospectively reviewed all patients at our institution who underwent venous sinus stenting for IIH over 6 years (July 1, 2012-June 30, 2018). A particular focus was dedicated to collecting demographic, clinical, radiologic, and outcomes data. All patients had failed medical management. RESULTS: Of the 110 patients evaluated for IIH, 42 underwent venous sinus stenting, with a mean follow-up of 25.6 months (range, 8.7-60.7 months). The mean age was 32 years (range, 15-52 years), 38 (90%) were women, and the mean body mass index was 35.6 kg/m2 (range, 18.6-47.5 kg/m2). Prior to the stenting procedure, all patients had headaches, visual disturbances, and papilledema. Of the 39 patients who had an ophthalmologic evaluation poststenting, 29 (74%) had resolution of their papilledema. Eighteen patients (43%) had complete resolution of their headaches after the stenting procedure, whereas 22 patients (52%) remained under a neurologist's care for chronic migraine and other types of headaches. Two patients underwent a restenting procedure for disease progression, and 1 patient experienced an in-stent thrombosis. CONCLUSIONS: A multidisciplinary approach involving neurosurgeons, ophthalmologists, radiologists, and neurologists is integral in the management of patients with IIH to prevent the complications of papilledema. Venous sinus stenting offers a safe and effective means of treating IIH. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/30248468/Endovascular_Treatment_for_Venous_Sinus_Stenosis_in_Idiopathic_Intracranial_Hypertension:_An_Observational_Study_of_Clinical_Indications_Surgical_Technique_and_Long_Term_Outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(18)32116-8 DB - PRIME DP - Unbound Medicine ER -