Introduction Lateral sinus stenosis represent a cause for intracranial hypertension and pulsatile tinnitus. Extrinsic aswell as intrinsic stenosis may be the target of endovascular treatment.

Aim of Study To present the initial experience of sinus stenosis treatment with the novel self-expanding large Acclino stent.

Methods Patient history, clinical findings and procedural data were reviewed. Diagnostic workup comprised neurological examination and in case of suspected intracranial hypertension ophthalmological evaluation. All patients also had internal jugular vein compression test to confirm the alteration of the pulsatile tinnitus. Imaging comprised contrast enhanced MRI, MR-Angiography and Time of flight MRA. Lumbar puncture with opening pressure measurement was performed in suspected IIH. All patients were treated under dual antiplatelet therapy.

Results Four consecutive patients were diagnosed with symptomatic transverse sinus stenosis. In two patients, intrinsic stenosis by large Pacchioni granulations and in two patients an extrinsic stenosis were identified as the cause of the pulsatile tinnitus and the intracranial hypertension respectively. Arterial and venous access were transfemoral. Pressure gradients were measured by using a 0.027 Headway 27 microcatheter. The same catheter was used for the deployment of Acclino 8.0x60.0mm stents. In all patients the stent led to a complete remodelling of the sinus stenosis with remission of the tinnitus and major relief in headache in the IIH patient. On angiographical control at three months, there was no in-stent stenosis and no recurrence of the stenosis.

Conclusion The large 8x60mm Acclino stent provides a very low profile system for the treatment of sinus stenosis.

Disclosure of Interest no.