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Original research
Intensive care unit admission is not necessary after venous sinus stenting
  1. Ankitha M Iyer1,
  2. Jackson P Midtlien1,
  3. Carol Kittel2,
  4. Kyle M Fargen1
  1. 1 Department of Neurological Surgery and Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
  2. 2 Division of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina, USA
  1. Correspondence to Dr Ankitha M Iyer, Department of Neurological Surgery and Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; aiyer{at}wakehealth.edu

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 to 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. A total of 166 (77.6%) patients underwent transverse sinus stenting alone; 9 (4.2%) underwent superior sagittal sinus (SSS) stenting alone, 37 (17.3) concomitant transverse and SSS stenting, and 2 (0.9%) underwent stenting at alternate sites. 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%) patients were discharged the following day. Major periprocedural 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 the ICU. No severe complications were identified after the PACU stay. During the next 48 hours after discharge, 4 (1.9%) patients returned to any emergency room 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.

  • stent
  • complication
  • intracranial pressure

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors Concept: KMF. Data acquisition: AMI, JPM. Statistical analysis: CK. Manuscript composition: all authors. Final approval: all authors. Guarantor: KMF.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Author KMF serves on the editorial board of JNIS.

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