Tags

Type your tag names separated by a space and hit enter

Reductions in bilateral transverse sinus pressure gradients with unilateral transverse venous sinus stenting for idiopathic intracranial hypertension.
J Neurointerv Surg. 2021 Feb; 13(2):187-190.JN

Abstract

BACKGROUND

Venous sinus stenting is an effective treatment for papilledema associated with idiopathic intracranial hypertension (IIH). It is unclear whether unilateral transverse-sigmoid sinus (TSS) stenting adequately decompresses the contralateral TSS system in cases of bilateral transverse sinus stenosis. The objective of this study was to compare changes in bilateral TSS pressure gradients following unilateral TSS stenting in a series of patients with IIH.

METHODS

Consecutive patients from a single institution who underwent venous sinus stenting for IIH with measurement of bilateral pressure gradients before and after stenting for IIH were enrolled. Pressure gradients in both TSS pre- and post-stenting were measured during the procedure. The TSS with the highest gradient was stented. Changes in TSS pressure gradients following stent placement were calculated for both TSS. Mean changes in pressure gradients of ipsilateral and contralateral TSS were calculated.

RESULTS

Sixteen patients with IIH who underwent TSS stenting were included. All were female. Mean age was 36.4 years. The right-sided TSS was the stented side in 12 (75.0%) patients. The mean pre-stent pressure gradient of the ipsilateral TSS was 19.3 mmHg (SD=10.8), which was reduced to a mean of 3.8 mmHg (3.4) following stent placement (P =<0.0001). On the contralateral (non-stented) side, the mean pre-stent gradient of 15.1 mmHg (7.5) was reduced to a mean of 7.8 mmHg (6.6) following stenting (P=0.006).

CONCLUSIONS

The use of a single stent provides some venous decompression of the contralateral non-stented stenosis in most cases of IIH treated with endovascular therapy.

Authors+Show Affiliations

Radiology, Mayo Clinic, Rochester, MN, USA. Neurosurgery, Mayo Clinic, Rochester, MN, USA.Neurosurgery, Mayo Clinic, Rochester, MN, USA.Neurology, Mayo Clinic, Rochester, Minnesota, USA.Neurology, Mayo Clinic, Rochester, Minnesota, USA.Radiology, Mayo Clinic, Rochester, MN, USA.Radiology, Mayo Clinic, Rochester, MN, USA Brinjikji.Waleed@mayo.edu. Neurosurgery, Mayo Clinic, Rochester, MN, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32482835

Citation

Larson, Anthony, et al. "Reductions in Bilateral Transverse Sinus Pressure Gradients With Unilateral Transverse Venous Sinus Stenting for Idiopathic Intracranial Hypertension." Journal of Neurointerventional Surgery, vol. 13, no. 2, 2021, pp. 187-190.
Larson A, Rinaldo L, Chen JJ, et al. Reductions in bilateral transverse sinus pressure gradients with unilateral transverse venous sinus stenting for idiopathic intracranial hypertension. J Neurointerv Surg. 2021;13(2):187-190.
Larson, A., Rinaldo, L., Chen, J. J., Cutsforth-Gregory, J., Theiler, A. R., & Brinjikji, W. (2021). Reductions in bilateral transverse sinus pressure gradients with unilateral transverse venous sinus stenting for idiopathic intracranial hypertension. Journal of Neurointerventional Surgery, 13(2), 187-190. https://doi.org/10.1136/neurintsurg-2020-016170
Larson A, et al. Reductions in Bilateral Transverse Sinus Pressure Gradients With Unilateral Transverse Venous Sinus Stenting for Idiopathic Intracranial Hypertension. J Neurointerv Surg. 2021;13(2):187-190. PubMed PMID: 32482835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reductions in bilateral transverse sinus pressure gradients with unilateral transverse venous sinus stenting for idiopathic intracranial hypertension. AU - Larson,Anthony, AU - Rinaldo,Lorenzo, AU - Chen,John J, AU - Cutsforth-Gregory,Jeremy, AU - Theiler,Amy R, AU - Brinjikji,Waleed, Y1 - 2020/06/01/ PY - 2020/04/14/received PY - 2020/04/29/revised PY - 2020/04/30/accepted PY - 2020/6/3/pubmed PY - 2021/4/21/medline PY - 2020/6/3/entrez KW - blood flow KW - intracranial pressure KW - stent KW - technique KW - vein SP - 187 EP - 190 JF - Journal of neurointerventional surgery JO - J Neurointerv Surg VL - 13 IS - 2 N2 - BACKGROUND: Venous sinus stenting is an effective treatment for papilledema associated with idiopathic intracranial hypertension (IIH). It is unclear whether unilateral transverse-sigmoid sinus (TSS) stenting adequately decompresses the contralateral TSS system in cases of bilateral transverse sinus stenosis. The objective of this study was to compare changes in bilateral TSS pressure gradients following unilateral TSS stenting in a series of patients with IIH. METHODS: Consecutive patients from a single institution who underwent venous sinus stenting for IIH with measurement of bilateral pressure gradients before and after stenting for IIH were enrolled. Pressure gradients in both TSS pre- and post-stenting were measured during the procedure. The TSS with the highest gradient was stented. Changes in TSS pressure gradients following stent placement were calculated for both TSS. Mean changes in pressure gradients of ipsilateral and contralateral TSS were calculated. RESULTS: Sixteen patients with IIH who underwent TSS stenting were included. All were female. Mean age was 36.4 years. The right-sided TSS was the stented side in 12 (75.0%) patients. The mean pre-stent pressure gradient of the ipsilateral TSS was 19.3 mmHg (SD=10.8), which was reduced to a mean of 3.8 mmHg (3.4) following stent placement (P =<0.0001). On the contralateral (non-stented) side, the mean pre-stent gradient of 15.1 mmHg (7.5) was reduced to a mean of 7.8 mmHg (6.6) following stenting (P=0.006). CONCLUSIONS: The use of a single stent provides some venous decompression of the contralateral non-stented stenosis in most cases of IIH treated with endovascular therapy. SN - 1759-8486 UR - https://www.unboundmedicine.com/medline/citation/32482835/Reductions_in_bilateral_transverse_sinus_pressure_gradients_with_unilateral_transverse_venous_sinus_stenting_for_idiopathic_intracranial_hypertension_ L2 - https://jnis.bmj.com/cgi/pmidlookup?view=long&amp;pmid=32482835 DB - PRIME DP - Unbound Medicine ER -