Article Text
Abstract
Background Venous Sinus Stenting (VSS) has emerged as a safe and effective treatment option for idiopathic intracranial hypertension. Many physicians routinely admit patients to the intensive care unit (ICU) for close monitoring, but little data exists on whether this is necessary.
Methods Electronic medical records of consecutive patients who underwent VSS by the senior author from 2016-2022 at a single center were reviewed.
Results 214 patients were included. The mean (SD) age was 35.5 (11.6) and 196 (91.6%) patients were female. The majority (77.5%) underwent transverse sinus stenting alone; the remainder underwent superior sagittal sinus stenting (SSS) alone (4.2%) or concomitant transverse and SSS stenting (17.2%). All patients were planned admission to the regular ward (27.6%) or day hospital (72.4%). Twenty (9.3%) patients were discharged to home the same day as the procedure and 182 (85%) of patients were discharged the following day. Major peri-procedural complications were identified in 2 (0.93%) patients and minor complications were identified in 16 (7.4%). Only one patient with a subdural hematoma identified in the post-anesthesia care unit (PACU) had care escalated to ICU. No severe complications were identified after the PACU stay. During the next 48 hours after discharge, 4 (1.9%) of patients returned to any ER to be evaluated without requiring readmission.
Conclusion Routine ICU admission following uncomplicated VSS is unnecessary. Overnight admission to a low-acuity ward, or even same-day discharge in select patients, appears to be a safe and cost-effective strategy.
Disclosures A. Iyer: None. J. Midtlien: None. C. Kittel: None. K. Fargen: None.