2021
DOI: 10.1007/s40120-021-00281-0
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Characteristics and Outcomes of the Idiopathic Intracranial Hypertension Treatment in Intrinsic and Extrinsic Stenosis: A Single-Center Experience in China

Abstract: Introduction: This study aimed to explore the precipitating factors and evaluate the impact of different stenosis types on treatment outcomes in patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). Methods: We recruited patients with IIH who presented with VSS, either intrinsic or extrinsic. We observed the clinical and laboratory findings, and we then compared the outcomes of stenting and medical treatment in different stenosis types. Results: Among 145 patients with IIH a… Show more

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Cited by 9 publications
(9 citation statements)
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“…One, prospective, nonrandomized trial comparing stenting to diet control and maximal medical therapy was carried out in Beijing and published in 2022. 19 Among those with intrinsic stenosis, they found a significantly higher rate of complete resolution of headaches (86.7% vs 23.1%), “visual impairment” (71.4% vs 12.5%), and papilledema (86.5% vs 42.9%) in the stented group vs the medical therapy group. Similar results were demonstrated for those with extrinsic stenosis in terms of headache (90/9% vs 40%), “visual impairment” (80% vs 45.5%), and papilledema (90.9% vs 36.8%).…”
Section: Head-to-head Trialsmentioning
confidence: 94%
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“…One, prospective, nonrandomized trial comparing stenting to diet control and maximal medical therapy was carried out in Beijing and published in 2022. 19 Among those with intrinsic stenosis, they found a significantly higher rate of complete resolution of headaches (86.7% vs 23.1%), “visual impairment” (71.4% vs 12.5%), and papilledema (86.5% vs 42.9%) in the stented group vs the medical therapy group. Similar results were demonstrated for those with extrinsic stenosis in terms of headache (90/9% vs 40%), “visual impairment” (80% vs 45.5%), and papilledema (90.9% vs 36.8%).…”
Section: Head-to-head Trialsmentioning
confidence: 94%
“…This framework could explain why intrinsic stenosis occurs most frequently at the transverse sinus because the sizable Vein of Labbe is a tributary with which vascular AGs are associated. 18 In light of studies demonstrating the efficacy of venous stenting for both the extrinsic and intrinsic type of stenosis, 19,20 it has been postulated that once an inciting event (i.e., weight gain) has led to intracranial hypertension and secondary extrinsic stenosis, the stenosis then leads to an even further elevation in ICP, compounding the stenosis, resulting in a positive feedback loop that only stabilizes once the transvenous wall pressure can no longer overcome dural compressibility. 21 It is also conceivable that in patients with intrinsic stenosis, intracranial hypertension is secondary to venous hypertension caused by impaired venous outflow.…”
Section: Theoretical Underpinningsmentioning
confidence: 99%
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“…In the cohort of our trial, we retrospectively selected 135 out of 173 patients from our registry named safety and efficacy of endovascular stenting for idiopathic intracranial hypertension with venous sinus stenosis 7 (Figure 1). Eleven patients were excluded due to poor imaging and angiography quality and 27 due to long stenosis segment extending from the SSS to the sigmoid sinus.…”
Section: Methodsmentioning
confidence: 99%
“…1 As the exploration of the underlying pathophysiology advances, more data suggest that elevated ICP is associated with lateral sinus stenosis and its elimination may lead to a significant reduction in ICP. 2,3 Since the first endovascular attempt to resolve IIH symptoms by Higgins et al, numerous studies [4][5][6] as well as our own registry study 7 have proven the efficacy and safety profile of venous sinus stenting for IIH. According to a recent review, over 90% of treated patients experienced significant papilledema improvement, and the major complication rate was as low as 1.5%.…”
Section: Introductionmentioning
confidence: 99%