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• W2895592588 abstract "Objective: To identify cases of idiopathic intracranial hypertension (IIH) treated with venous sinus stenting (VSS), summarize the patient population and outcomes, and determine rates of complication. Background: IIH is characterized by raised intracranial pressure outside the context of space-occupying or obstructive lesions. It is well accepted that most IIH patients have transverse sinus stenosis impairing cerebral venous outflow. Untreated, this may cause optic nerve damage and permanent visual loss. The reported annual incidence is 0.9–1.07/100,000 but may reach 15–19/100,000 in subpopulations of overweight women aged 20–44. Medically refractory IIH has historically been treated by therapeutic lumbar punctures, cerebrospinal fluid (CSF) diversion, and optic nerve sheath fenestration. Recurrence rates with medication have reached 40%. Shunt failure and revision rates are as high as 60% with infection-related complications reaching 10%. ONSF carries significant risks with failure rates and concomitant recurrence of visual symptoms up to 32%. Since 2002, VSS has emerged as an alternative treatment option for refractory IIH. Design/Methods: A systematic literature review was performed to identify all patients with IIH who underwent treatment with VSS. Relevant data on demographics, clinical course, and outcomes were extracted. Results: A total of 518 subjects were identified (89% female, mean age 34.6+/− 7.4y, mean body mass index 34.9+/−6.3 kg/m2). Initial symptoms included headache(92%), resolved/improved in 76% post-stenting; papilledema(82%), resolved/improved in 88%; visual defects (63%), resolved/improved in 83%; and pulse-synchronous tinnitus(34%), resolved in 94%. Mean follow-up was 16.8+/−11.2 m clinically and 16.9+/−19.3 m radiologically. Mean stenotic pressure gradient improved from 18.4+/−7.6 mmHg to 3.2+/−3.0 mmHg after stenting. The complication rate was 18.9% with an 8.9% re-stenting rate and a 3.4% post-stent surgical re-treatment rate. Conclusions: VSS is a safe and effective alternative to invasive treatments, such as CSF diversion and ONSF, in patients with IIH. Given the excellent clinical outcomes documented in the literature, further investigation with a multi-center randomized clinical trial would be beneficial. Disclosure: Dr. Bond has nothing to disclose. Dr. Bond has nothing to disclose. Dr. Ilorah has nothing to disclose. Dr. Kattah has nothing to disclose." @default.
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• W2895592588 date "2018-04-10" @default.
• W2895592588 modified "2023-09-23" @default.
• W2895592588 title "Endovascular Venous Sinus Stenting for Refractory Idiopathic Intracranial Hypertension: A Systematic Review of the Literature (P1.203)" @default.
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