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Original research
Venous sinus stenting lowers the intracranial pressure in patients with idiopathic intracranial hypertension
  1. Athos Patsalides1,
  2. Cristiano Oliveira2,3,
  3. Jessica Wilcox2,
  4. Kenroy Brown1,
  5. Kartikey Grover4,
  6. Yves Pierre Gobin1,
  7. Marc J Dinkin2,3
  1. 1 Division of Interventional Neuroradiology, Department of Neurological Surgery, Weill Cornell Medine, New York, USA
  2. 2 Department of Neurology, Weill Cornell Medicine, New York, USA
  3. 3 Department of Ophthalmology, Weill Cornell Medicine, New York, USA
  4. 4 Department of Medical Statistics, Weill Cornell Medicine, New York, USA
  1. Correspondence to Dr Athos Patsalides, Division of Interventional Neuroradiology, Department of Neurological Surgery, Weill Cornell Medine, New York, NY 10065, USA; atp9002{at}med.cornell.edu

Abstract

Aims We report the cerebrospinal fluid opening pressure (CSF-OP) measurements obtained before and after venous sinus stenting (VSS) in 50 patients with idiopathic intracranial hypertension.

Methods The CSF-OP was measured with a spinal tap 3 months before and 3 months after treatment. All data were prospectively collected and included patient demographics, weight (kg), body mass index (BMI), acetazolamide daily dosage (mg), procedural details, complications, venous sinus pressures (mm Hg), trans-stenotic pressure gradient (mm Hg), transverse sinus symmetry, and type of venous sinus stenosis.

Results The average pretreatment CSF-OP was 37 cm H2O (range 25–77) and the average post-treatment CSF-OP was 20.2 cm H2O (range 10–36), with an average reduction of 16.8 cm H2O (P<0.01). The post-treatment CSF-OP was less than 25 cm H2O in 40/50 patients. The average acetazolamide daily dose decreased from 950 mg to 300 mg at the time of 3-month follow-up (P<0.01). No patient required an increase in acetazolamide dose 3 months after VSS. The average weight before treatment was 95.4 kg with an average BMI of 35.41. There was an average increase in body weight of 1.1 kg at the 3-month follow-up with an average increase in BMI of 0.35 (P=0.03).

Conclusions We provide evidence that there is a significant decrease in CSF-OP in patients with idiopathic intracranial hypertension 3 months after VSS, independent of acetazolamide usage or weight loss.

  • intracranial pressure
  • stent
  • stenosis
  • vein

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Footnotes

  • Contributors AP: Substantial contributions to the conception and design, acquisition, analysis, and interpretation of data; guarantor of the paper. CO: Substantial contributions to the conception and design; critical revision of the manuscript for important intellectual content. JW: Acquisition of data. KB: Acquisition of data. KG: Statistical analysis and interpretation. YPG: Substantial contributions to the conception and design of the work; critical revision of the manuscript for important intellectual content. MD: Substantial contributions to the conception and design of the work; critical revision of the manuscript for important intellectual content.

  • Funding KG: This work was supported by Clinical and Translational Science Center at Weill Cornell Medical College grant number (1-UL1-TR002384-01).

  • Competing interests Dr Gobin is the founder, medical director and CEO of Serenity Medical None declared.

  • Patient consent Not required.

  • Ethics approval Weill Cornell Medicine IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unprocessed data are available upon request from the corresponding author.

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