Primary balloon angioplasty of venous Sinus stenosis in idiopathic intracranial hypertension

Background Venous sinus stenosis (VSS) stenting has emerged as an effective treatment for patients with Idiopathic Intracranial Hypertension (IIH). However, stenting carries risk of in-stent stenosis/thrombosis and cumulative bleeding risk from long-term dual antiplatelet (DAPT) use. Thus, we invest...

Full description

Saved in:
Bibliographic Details
Published in:Interventional neuroradiology 2023-08, Vol.29 (4), p.358-362
Main Authors: Carlos Martinez-Gutierrez, Juan, Kole, Matthew J, Lopez-Rivera, Victor, Inam, Mehmet Enes, Tang, Rosa, Al-Zubidi, Nagham, Adesina, Ore-Ofeoluwatomi, Lekka, Elvira, Engstrom, Allison C., Sheth, Sunil, Pedroza, Claudia, Day, Arthur L., Chen, Peng Roc
Format: Article
Language:English
Subjects:
Angioplasty, Balloon
Constriction, Pathologic - complications
Constriction, Pathologic - therapy
Cranial Sinuses - surgery
Female
Humans
Intracranial Hypertension
Male
Original s
Pseudotumor Cerebri - diagnostic imaging
Pseudotumor Cerebri - surgery
Retrospective Studies
Stents - adverse effects
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Venous sinus stenosis (VSS) stenting has emerged as an effective treatment for patients with Idiopathic Intracranial Hypertension (IIH). However, stenting carries risk of in-stent stenosis/thrombosis and cumulative bleeding risk from long-term dual antiplatelet (DAPT) use. Thus, we investigated the potential safety and efficacy of primary balloon angioplasty as an alternative to stenting in IIH. Methods A prospectively maintained single-center registry of IIH patients undergoing endovascular procedures was queried. Inclusion criteria included patients with confirmed IIH and angiographically demonstrable VSS who underwent interventions from 2012- 2021. Patients were dichotomized into primary balloon angioplasty (Group A) and primary stenting (Group S), comparing clinical outcomes using bivariate analyses. Results 62 patients were included with median age of 33 [IQR 26-37], 74% females. Group A (9/62) and Group S (53/62) had similar baseline characteristics. Papilledema improvement was higher in Group S at 6 weeks and 6 months (44 vs. 93, p = 0.002 and 44 vs. 92%, p = 0.004), with similar improvements across all symptoms. Group S had higher mean post-procedure venous pressure gradient change (8 vs. 3 mmHg, p = 0.02) and a lower CSF opening pressure at 6 months (23 vs. 36 cmH2O, p 
ISSN:1591-0199
2385-2011
2385-2011
DOI:10.1177/15910199221089446