Efficacy of patients with idiopathic intracranial hypertension syndrome complicated with venous sinus stenosis treated with stent angioplasty via jugular vein approach

Abstract

Objective To investigate the safety and effectiveness of patients with idiopathic intracranial hypertension (IIH) syndrome complicated with cerebral venous sinus stenosis (CVSS) treated with stent angioplasty via jugular vein approach. Methods Twenty-seven patients with IIH complicated with CVSS treated with stent angioplasty via jugular vein approach at the Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University from July 2013 to September 2015 were analyzed retrospectively. Their clinical efficacy was observed. Results The pressure differences at both ends of the stenosis were 14-32 mmHg (mean 18±14 mmHg) in 27 cases before treatment. The stents were successfully implanted in 26 cases. The venous sinus stenosis disappeared after procedure. The pressure difference at both ends of the stenosis was reduced to 0-1 mmHg. The treatment failed in 1 case and he was treated with balloon dilatation, but postoperative stenosis was not improved significantly. No intraoperative and postoperative complications associated with surgery occurred in this group. Twenty-seven patients were followed up for a mean of 9.5 months (3-19 months), 19 did not have any symptoms, and the symptoms of 7 cases were improved. More than a month after stenting, the papilledema of the patients was obviously improved. In addition to the improvement of postoperative visual acuity not obvious in 4 cases, others were improved at 1 month after procedure. Three months after procedure, 16 cases underwent CT venography. After 6 months, 10 patients were examined with DSA. They all showed that the stents were patent and no restenosis occurred. Conclusion Stent angioplasty via jugular approach for the treatment of patients with IIH complicated with CVSS may be a safe and effective method. Key words: Pseudotumor cerebri; Cranial sinuses; Constriction, pathologic; Angioplasty