Tara Samiee1, Anqi Luo2, Sujani Bandela2, Alibay Jafarli2, Sivani Lingam1, Aspin Denson1, Iheanyi Amadi1, Anna Speckin1, Michael Gaub2, Sai Kumar Reddy Pasya1, Liam Lynch1, Gretchen Gealogo2, Michael Abraham3, Lee Birnbaum2
1University of Kansas Medical Center, 2UT Health San Antonio, 3The University of Kansas Health System
Objective:
To examine the demographics and clinical outcomes of patients who underwent cerebral venous sinus stenting (VSS) for medically refractory idiopathic intracranial hypertension (IIH) across two tertiary hospitals in the United States.
Background:
IIH is characterized by increased intracranial pressure, commonly presenting with headaches, visual disturbances, and pulsatile tinnitus. Traditional surgical intervention involves cerebrospinal fluid diversion, but many patients require shunt revision. While cerebral VSS is emerging as an alternative, large multicenter studies, particularly those identifying predictors for repeat stenting, remain limited.
Design/Methods:
A retrospective analysis was conducted on IIH patients treated with VSS at two tertiary hospitals from 2012 to 2024. Demographics, baseline clinical characteristics, and clinical outcomes were evaluated for up to 12 months post-treatment.
Results:
Among 168 IIH patients (mean age 39 years), 92.3% were female (n=155). The mean pressure gradient across the stenosis decreased significantly from 14.96 pre-stenting to 1.28 mmHg post-stenting (P<0.001). Headaches (86.4%) and pulsatile tinnitus (69.7%) improved post-stenting. Papilledema, using Frisen grading, decreased significantly in both eyes from 68.9% to 34% post-stenting (P<0.001). Repeat stenting occurred in 18 patients (10.7%) and was significantly more likely in those with stent adjacent stenosis (P<0.001). Initial tinnitus (P=0.03), as the primary concern among symptoms, was a significant predictor of requiring repeat stenting. Higher BMI (P=0.20) and left-sided venous sinus stenosis (P=0.12) were associated with repeat stenting but were not statistically significant. Stent type did not have a significant impact on repeat stenting (P=0.27).
Conclusions:
Our preliminary data suggest that VSS is effective for medically refractory IIH and carries a low risk of repeat stenting. We hypothesize that a higher BMI and left-sided venous sinus stenosis may also be predictors for requiring repeat stenting. Our study is ongoing, and we will confirm these findings upon its completion.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.