RT Journal Article
SR Electronic
T1 Dural venous sinus stenting for treatment of pediatric idiopathic intracranial hypertension
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 465
OP 470
DO 10.1136/neurintsurg-2020-016183
VO 13
IS 5
A1 Katriel E Lee
A1 Aqib Zehri
A1 Sauson Soldozy
A1 Hasan Syed
A1 Joshua S Catapano
A1 Robert Maurer
A1 Felipe C Albuquerque
A1 Kenneth C Liu
A1 Stacey Q Wolfe
A1 Sandra Brown
A1 Michael R Levitt
A1 Kyle M Fargen
YR 2021
UL http://jnis.bmj.com/content/13/5/465.abstract
AB Background Dural venous sinus stenting (VSS) is an effective treatment for idiopathic intracranial hypertension (IIH) in adult patients. There are no published series to date evaluating safety and efficacy of VSS in pediatric patients.Objective To report on procedural device selection and technique as well as safety and efficacy of VSS for pediatric patients with medically refractory IIH due to underlying venous sinus stenosis.Methods A multi-institutional retrospective case series identified patients with medically refractory IIH aged less than 18 years who underwent VSS.Results 14 patients were identified at four participating centers. Patient ages ranged from 10 to 17 years, and 10 patients (71.4%) were female. Mean body mass index was 25.7 kg/m2 (range 15.8–34.6 kg/m2). Stenting was performed under general endotracheal anesthesia in all except two patients. The average trans-stenotic gradient during diagnostic venography was 10.6 mm Hg. Patients had stents placed in the superior sagittal sinus, transverse sinus, sigmoid sinus, occipital sinus, and a combination. Average follow-up was 1.7 years after stenting. Six patients out of 10 (60%) had reduced medication dosing, 12 of 14 patients (85.7%) had improvements in headaches, two patients (100%) with pre-stent tinnitus had resolution of symptoms, and four (80%) of five patients with papilledema had improvement on follow-up ophthalmological examinations. Two patients (14.3%) developed postprocedural groin hematomas, one patient (7.1%) developed a groin pseudoaneurysm, and one patient (7.1%) had postprocedural groin bleeding. No other procedural complications occurred. Four patients (28.6%) required further surgical treatment (cerebrospinal shunting and/or stenting) after their first stenting procedure.Conclusions This series suggests that VSS is feasible in a pediatric population with IIH and has a low complication rate and good clinical outcomes.All data relevant to the study are included in the article or uploaded as supplementary information.