Introduction/Purpose Idiopathic intracranial hypertension (IIH) is characterized by an elevated intracranial pressure without any identifiable causative factor such as an intracranial mass. Venous sinus stenosis has been increasingly known as a treatable cause of elevated intracranial pressure in patients with medically refractory IIH. We aimed to perform a systematic review and analysis of outcomes and complications in all patients undergoing dural venous sinus stenting (DVSS) for the management of medically refractory IIH.
Materials and methods We searched PubMed and Google Scholar 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 418 patients were included in our analysis from 30 studies. Headache was present in 386 (92%) of patients and resolved or improved in 293 (76%) after DVSS. Tinnitus resolved in 95% (129/136) of patients after venous stenting. Papilledema and visual changes improved in 87% (284/327) and 85% (211/247) of patients following DVSS. Overall, 46 (12.2%) of patients required re-treatment with re-stenting or other surgical procedures. The rate of major neurological complications was less than 0.1%.
Conclusions Our results add to the growing body of literature that proposes DVSS as a safe treatment option with high clinical success rate and low complications in patients with medically refractory IIH and evidence of venous stenosis.
Disclosures H. Saber: None. P. Chamiraju: None. S. Narayanan: None.
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