Hamidreza Saber1, Whitfield Lewis1, Mahsa Sadeghi1, Gary Rajah2, Sandra Narayanan1,2. 1. Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA. 2. Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
Abstract
BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterized by an elevated intracranial pressure without any identifiable causative factor such as an intracranial mass. Dural venous sinus stenosis (DVSS) has been suggested to be associated with IIH. OBJECTIVE: We performed an updated systematic review and meta-analysis to determine clinical outcomes as well as stent survival and stent-adjacent stenosis rates in patients undergoing DVSS for the management of medically refractory IIH. METHODS: We searched PubMed, Embase, and Cochrane databases to identify prospective or retrospective cohorts or case series of patients with IIH treated with DVSS between 2000 and 2017. RESULTS: A total of 473 patients were included from 24 studies. Headache was present in 429 (91.8%) patients and resolved or improved in 319/413 (77.2%) after the procedure. Headache, papilledema, visual acuity, and tinnitus improved in 256/330 (77.6%), 247/288 (85.8%), 121/172 (70.3%), and 93/110 (84.5%) patients following DVSS at the final follow-up (mean of 18.3 months). In a meta-analysis of 395 patients with available follow-up data on stenting outcome (mean of 18.9 months), the stent survival and stent-adjacent stenosis rates were 84% (95% confidence interval [CI] 79-87%) and 14% (95% CI 11-18%), respectively. The rate of major neurological complications was less than 2%. CONCLUSION: Stent-adjacent stenosis is an important complication following venous stenting in patients with DVSS and IIH. Further studies are needed to identify determinants of stent-adjacent stenosis and stent nonsurvival.
BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterized by an elevated intracranial pressure without any identifiable causative factor such as an intracranial mass. Dural venous sinus stenosis (DVSS) has been suggested to be associated with IIH. OBJECTIVE: We performed an updated systematic review and meta-analysis to determine clinical outcomes as well as stent survival and stent-adjacent stenosis rates in patients undergoing DVSS for the management of medically refractory IIH. METHODS: We searched PubMed, Embase, and Cochrane databases to identify prospective or retrospective cohorts or case series of patients with IIH treated with DVSS between 2000 and 2017. RESULTS: A total of 473 patients were included from 24 studies. Headache was present in 429 (91.8%) patients and resolved or improved in 319/413 (77.2%) after the procedure. Headache, papilledema, visual acuity, and tinnitus improved in 256/330 (77.6%), 247/288 (85.8%), 121/172 (70.3%), and 93/110 (84.5%) patients following DVSS at the final follow-up (mean of 18.3 months). In a meta-analysis of 395 patients with available follow-up data on stenting outcome (mean of 18.9 months), the stent survival and stent-adjacent stenosis rates were 84% (95% confidence interval [CI] 79-87%) and 14% (95% CI 11-18%), respectively. The rate of major neurological complications was less than 2%. CONCLUSION: Stent-adjacent stenosis is an important complication following venous stenting in patients with DVSS and IIH. Further studies are needed to identify determinants of stent-adjacent stenosis and stent nonsurvival.
Authors: R M Ahmed; M Wilkinson; G D Parker; M J Thurtell; J Macdonald; P J McCluskey; R Allan; V Dunne; M Hanlon; B K Owler; G M Halmagyi Journal: AJNR Am J Neuroradiol Date: 2011-07-28 Impact factor: 3.825
Authors: A H Y Chiu; A K Cheung; J D Wenderoth; L De Villiers; H Rice; C C Phatouros; T P Singh; T J Phillips; W McAuliffe Journal: AJNR Am J Neuroradiol Date: 2015-05-21 Impact factor: 3.825
Authors: Felipe C Albuquerque; Shervin R Dashti; Yin C Hu; C Benjamin Newman; Mohamed Teleb; Cameron G McDougall; Harold L Rekate Journal: World Neurosurg Date: 2011 May-Jun Impact factor: 2.104
Authors: Tarek A Shazly; Ashutosh P Jadhav; Amin Aghaebrahim; Andrew F Ducruet; Brian T Jankowitz; Tudor G Jovin; Gabrielle R Bonhomme Journal: J Neurointerv Surg Date: 2017-05-09 Impact factor: 5.836
Authors: Darian R Esfahani; Matthew Stevenson; Heather E Moss; Sepideh Amin-Hanjani; Victor Aletich; Sachin Jain; Fady T Charbel; Ali Alaraj Journal: Neurosurgery Date: 2015-08 Impact factor: 4.654
Authors: A Donnet; P Metellus; O Levrier; C Mekkaoui; S Fuentes; H Dufour; J Conrath; F Grisoli Journal: Neurology Date: 2008-02-19 Impact factor: 9.910
Authors: Justin Schwarz; Ali Al Balushi; Sri Sundararajan; Marc Dinkin; Cristiano Oliveira; Jeffrey P Greenfield; Athos Patsalides Journal: Interv Neuroradiol Date: 2020-11-25 Impact factor: 1.610
Authors: Philipp Hendrix; Christopher J Whiting; Christoph J Griessenauer; Christian Bohan; Clemens M Schirmer; Oded Goren Journal: Neurosurg Rev Date: 2022-01-24 Impact factor: 3.042
Authors: Olivia Grech; Susan P Mollan; Benjamin R Wakerley; Zerin Alimajstorovic; Gareth G Lavery; Alexandra J Sinclair Journal: J Neurol Date: 2020-07-22 Impact factor: 4.849