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Dural venous sinus stenting technique for idiopathic intracranial hypertension in patients with tortuous venous anatomy.
Gorjian, Mehrnoush; Andrada, Jason E; Sitko, Kevin R; Sorte, Danielle E; Taylor, Christopher L; Eliyas, Javed Khader; Carlson, Andrew P.
Afiliação
  • Gorjian M; University of New Mexico, Albuquerque, NM, 87131, USA.
  • Andrada JE; University of New Mexico, Albuquerque, NM, 87131, USA.
  • Sitko KR; University of New Mexico, Albuquerque, NM, 87131, USA.
  • Sorte DE; University of New Mexico, Albuquerque, NM, 87131, USA.
  • Taylor CL; UMCP Neurosurgery, 3502 9TH ST, Lubbock, TX, 79415, USA.
  • Eliyas JK; Saint Francis Hospital, Hartford, CT, 06105, USA.
  • Carlson AP; Department of Neurosurgery, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA. andrewcarlson@salud.unm.edu.
Neurosurg Rev ; 46(1): 177, 2023 Jul 18.
Article em En | MEDLINE | ID: mdl-37462792
ABSTRACT
Venous sinus stenting (VSS) for medically refractory idiopathic intracranial hypertension (IIH) is emerging as a safe and effective alternative to shunting. However, stent navigation past the jugular bulb with commonly used carotid stenting systems via femoral access in cases with tortuous venous anatomy can present a challenge, leading to procedural failure. We present a technical refinement using a cervical access and peripheral vascular stent with a more stable 0.035-in. delivery platform as an alternative to the traditional approach to simplify the procedure and overcome the technical difficulties in cases with tortuous venous anatomy. Our institutional database for patients who had IIH and undergone VSS using the peripheral vascular stent between 2013 and 2023 was retrospectively reviewed. Data on 36 patients (33 women, 3 men, mean age 32 years) was collected. VSS was technically successful in all patients (100%) without major complications or thrombosis. There was one case of minor neck cellulitis treated with oral antibiotics. Three patients underwent repeat stenting, and 2 patients had ventriculoperitoneal shunt placement after stenting due to persistent or recurrent symptoms. All patients (100%) had improvement or resolution of papilledema; however, six patients had evidence of optic atrophy and persistent vision loss. Headache was resolved or improved in 91% of patients. In the presence of tortuous venous anatomy, VSS using cervical access and a peripheral vascular stent with a more stable 0.035-in. delivery platform can be considered as a safe and effective alternative approach with shorter procedure time. This approach is particularly advantageous in situations where the procedure is prolonged or high dose of contrast has been administered due to the technical challenges associated with the traditional use of carotid systems via femoral access for stent delivery.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pseudotumor Cerebral / Hipertensão Intracraniana Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Neurosurg Rev Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pseudotumor Cerebral / Hipertensão Intracraniana Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Neurosurg Rev Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos