Details

Autor(en) / Beteiligte

• Azzam, Ahmed Y.
• Mortezaei, Ali
• Morsy, Mahmoud M.
• Essibayi, Muhammed Amir
• Ghozy, Sherief
• Elamin, Osman
• Azab, Mohammed A.
• Elswedy, Adam
• Altschul, David
• Kadirvel, Ramanathan
• Brinjikji, Waleed
• Kallmes, David F.

Titel

Venous sinus stenting for idiopathic intracranial hypertension: An updated Meta-analysis

Ist Teil von

• Journal of the neurological sciences, 2024-04, Vol.459, p.122948-122948, Article 122948

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2024

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure and primarily affects obese women of reproductive age. Venous sinus stenting (VSS) is a surgical procedure used to treat IIH, but its safety and efficacy are still controversial. A systematic review and meta-analysis were conducted following PRISMA guidelines. Multiple databases were searched for studies evaluating the safety and efficacy of VSS in IIH patients and meta-analysis was performed to pool the data. A total of 36 studies involving 1066 patients who underwent VSS were included. After VSS, a significant reduction in trans-stenotic gradient pressure was observed. Patients also showed significantly lower cerebrospinal fluid (CSF) opening pressure. Clinical outcomes demonstrated improvement in tinnitus (95%), papilledema (89%), visual disturbances (88%), and headache (79%). However, 13.7% of patients experienced treatment failure or complications. The treatment failure rate was 8.35%, characterized by worsening symptoms and recurrence of IIH. The complications rate was 5.35%, including subdural hemorrhage, urinary tract infection, stent thrombus formation, and others. VSS appears to be a safe and effective treatment option for IIH patients who are unresponsive to medical therapy or have significant visual symptoms. However, long-term outcomes and safety of the procedure require further investigation. •Patients showed significant improvement in idiopathic intracranial hypertension (IIH) symptoms post-venous sinus stenting (VSS), with 79% experiencing reduced headaches, 89% improvement in papilledema, and 88% relief in diplopia or visual disturbances.•VSS demonstrated a promising potential as a minimally invasive treatment for IIH, especially in patients who did not respond to medical therapy or had significant visual symptoms. It significantly reduced symptoms with a relatively low complication rate.•Post-VSS, there was a significant reduction in both the trans-stenotic gradient pressure and the lumbar puncture cerebrospinal fluid opening pressure, indicating effective alleviation of intracranial pressure.•The study reported a major complication rate of 3.93% and a minor complication rate of 2.72% post-VSS, indicating that the procedure is relatively safe with manageable risks.