RT Journal Article
SR Electronic
T1 Efficacy of stenting in patients with cerebral venous sinus thrombosis-related cerebral venous sinus stenosis
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 307
OP 312
DO 10.1136/neurintsurg-2018-014328
VO 11
IS 3
A1 Ke Li
A1 Ming Ren
A1 Ran Meng
A1 Yuchuan Ding
A1 Gary B Rajah
A1 Feng Wang
A1 Xunming Ji
YR 2019
UL http://jnis.bmj.com/content/11/3/307.abstract
AB Background Venous stenting has been proven to be a safe and effective therapeutic option for patients with idiopathic intracranial hypertension (IIH) and cerebral venous sinus stenosis (CVSS). However, its use in patients with cerebral venous sinus thrombosis-related CVSS has been less reported.Purpose To explore the safety and efficacy of stenting for patients with cerebral venous sinus thrombosis (CVST)-related CVSS.Methods The clinical presentation, treatment, and outcome of patients with CVST-related CVSS received venous stenting in the chronic stage after failed medical treatment were retrospectively evaluated.Results A total of 17 patients with CVST-related CVSS were included. Mean pressure gradient across the CVSS decreased from 11.5±4.2 mmHg prior to stenting to 2.1±1.1 mmHg post- stenting. Mean CSF opening pressure decreased from 33.1±5.5 cmH2O to 18.7±1.7 cmH2O. Both headache and visual disturbance improved or resolved in 78% and 92% of the patients, respectively. Complications included lethal cerebellar hematoma in one case and bilateral occipital epidural hematoma in another case. One of the patients received retreatment with ventriculo-peritoneal shunting due to recurrent headache.Conclusion Restoring the patency of stenotic sinuses with stents in patients of CVST-related CVSS unresponsive to medical therapy in the chronic stage may improve symptoms in the majority of the patients. However, a relatively higher cerebral hemorrhage rate was observed and may be related to this pathology. Stenting in this subgroup of CVSS patients may require further evaluation with a larger and long-term study, and should be used with caution at this time.