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Dural venous sinus stenting for treatment of pediatric idiopathic intracranial hypertension.
Lee, Katriel E; Zehri, Aqib; Soldozy, Sauson; Syed, Hasan; Catapano, Joshua S; Maurer, Robert; Albuquerque, Felipe C; Liu, Kenneth C; Wolfe, Stacey Q; Brown, Sandra; Levitt, Michael R; Fargen, Kyle M.
Affiliation
  • Lee KE; Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
  • Zehri A; Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
  • Soldozy S; Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia, USA.
  • Syed H; Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, Virginia, USA.
  • Catapano JS; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
  • Maurer R; Penn State Health Neurosurgery, Hershey, Pennsylvania, USA.
  • Albuquerque FC; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
  • Liu KC; Department of Neurological Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
  • Wolfe SQ; Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
  • Brown S; Cabarrus Eye Center, Concord, North Carolina, USA.
  • Levitt MR; Department of Neurological Surgery, Radiology and Mechanical Engineering, University of Washington, Seattle, Washington, USA.
  • Fargen KM; Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA kfargen@wakehealth.edu.
J Neurointerv Surg ; 13(5): 465-470, 2021 May.
Article de En | MEDLINE | ID: mdl-32732257
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.
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Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Syndrome d'hypertension intracrânienne bénigne / Endoprothèses / Procédures de neurochirurgie / Sinus veineux crâniens Type d'étude: Observational_studies / Prognostic_studies Limites: Adolescent / Child / Female / Humans / Male Langue: En Journal: J Neurointerv Surg Année: 2021 Type de document: Article Pays d'affiliation: États-Unis d'Amérique Pays de publication: Royaume-Uni

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Syndrome d'hypertension intracrânienne bénigne / Endoprothèses / Procédures de neurochirurgie / Sinus veineux crâniens Type d'étude: Observational_studies / Prognostic_studies Limites: Adolescent / Child / Female / Humans / Male Langue: En Journal: J Neurointerv Surg Année: 2021 Type de document: Article Pays d'affiliation: États-Unis d'Amérique Pays de publication: Royaume-Uni