Lakshmi Leishangthem1, Pooja SirDeshpande2, Dharti Dua3, Sudhakar R Satti4. 1. Department of Neurology, Albert Einstein medical center, 5401 Old York Road, 19141 Philadelphia, PA, USA. Electronic address: leishanl@einstein.edu. 2. Department of Neurosurgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA. Electronic address: drpooja0916@gmail.com. 3. Department of Neurology, Ohio State University, Columbus, OH, USA. Electronic address: drgul85@gmail.com. 4. Department of Neuro Interventional Surgery, Christiana Care Hospital, Newark, Delaware, USA. Electronic address: ssatti@christianacare.org.
Abstract
BACKGROUND: Dural venous sinus stenting (DVSS) is an accepted treatment option in selected patients with medically refractory idiopathic intracranial hypertension and obstructive venous outflow physiology prior to cerebrospinal flow diversion (CSFD) surgery. There are no randomized controlled studies focusing on outcomes and complication rates for dural venous sinus stenting. PURPOSE: We present the largest comprehensive meta-analysis on DVSS for idiopathic intracranial hypertension (IIH) focusing on success rates, complications, and re-stenting rates to date. We also present a simplified approach to direct retrograde internal jugular vein (IJ) access for DVSS that allows for expedited procedures. MATERIALS AND METHODS: We performed a retrospective electronic PubMed query of all peer-reviewed articles in the last 15 years between 2003 to 2018. We included all patients who underwent dural venous sinus stenting for a medically refractive IIH and excluded articles without sufficient data on outcomes, complication rates and re-stenting rates. We also evaluated and compared outcomes in patients undergoing direct retrograde IJ access DVSS to traditional transfemoral vein access. RESULTS: A total of 29 papers and 410 patients who underwent DVSS met criteria for inclusion. DVSS was associated with high technical success [99.5%], low rates of repeated procedure [10%], and low major complication rates [1.5%]. CONCLUSION: Our retrospective comprehensive review of DVSS for medically refractory IIH suggests that stenting in appropriately chosen patients is associated with low complication rates, high technical success, and low repeat procedure rates.
BACKGROUND: Dural venous sinus stenting (DVSS) is an accepted treatment option in selected patients with medically refractory idiopathic intracranial hypertension and obstructive venous outflow physiology prior to cerebrospinal flow diversion (CSFD) surgery. There are no randomized controlled studies focusing on outcomes and complication rates for dural venous sinus stenting. PURPOSE: We present the largest comprehensive meta-analysis on DVSS for idiopathic intracranial hypertension (IIH) focusing on success rates, complications, and re-stenting rates to date. We also present a simplified approach to direct retrograde internal jugular vein (IJ) access for DVSS that allows for expedited procedures. MATERIALS AND METHODS: We performed a retrospective electronic PubMed query of all peer-reviewed articles in the last 15 years between 2003 to 2018. We included all patients who underwent dural venous sinus stenting for a medically refractive IIH and excluded articles without sufficient data on outcomes, complication rates and re-stenting rates. We also evaluated and compared outcomes in patients undergoing direct retrograde IJ access DVSS to traditional transfemoral vein access. RESULTS: A total of 29 papers and 410 patients who underwent DVSS met criteria for inclusion. DVSS was associated with high technical success [99.5%], low rates of repeated procedure [10%], and low major complication rates [1.5%]. CONCLUSION: Our retrospective comprehensive review of DVSS for medically refractory IIH suggests that stenting in appropriately chosen patients is associated with low complication rates, high technical success, and low repeat procedure rates.
Authors: Robert Kyle Townsend; Alec Jost; Matthew R Amans; Ferdinand Hui; Matthew T Bender; Sudhakar R Satti; Robert Maurer; Kenneth Liu; Waleed Brinjikji; Kyle M Fargen Journal: J Neurointerv Surg Date: 2021-04-28 Impact factor: 5.836
Authors: Anirudh Arun; Matthew R Amans; Nicholas Higgins; Waleed Brinjikji; Mithun Sattur; Sudhakar R Satti; Peter Nakaji; Mark Luciano; Thierry Agm Huisman; Abhay Moghekar; Vitor M Pereira; Ran Meng; Kyle Fargen; Ferdinand K Hui Journal: Neuroradiol J Date: 2021-07-05
Authors: Nebiyat F Belachew; Severin Baschung; William Almiri; Ruben Encinas; Johannes Kaesmacher; Tomas Dobrocky; Christoph J Schankin; Mathias Abegg; Eike I Piechowiak; Andreas Raabe; Jan Gralla; Pasquale Mordasini Journal: Clin Neuroradiol Date: 2021-05-18 Impact factor: 3.649