Patency of the vein of Labbé after venous stenting of the transverse and sigmoid sinuses

Abstract

In the majority of venous stenting cases involving the transverse and sigmoid sinuses, the VOL remains widely patent. Complete VOL occlusion rarely occurs after stenting and may not result in clinical sequelae. Stent coverage of the VOL should not deter the therapeutic use of venous sinus stenting.

Impaired drainage of vein of Labbé following venous sinus stenting for idiopathic intracranial hypertension

“…In 2017, Raper et al 6 reported a 25% incidence of impaired VOL flow immediately following VSS. The reported 25% incidence is based on 32 patients with post-stent arteriography, which constitutes only 57% of the cohort of patients with VSS, as the remaining 43% were lacking control arteriography following VSS.…”

“…Levitt et al 5 reported no immediate occlusions of the VOL after VSS. In contradistinction, Raper et al 6 reported abnormal findings in the VOL after VSS in 25% of patients immediately post-treatment and in 28% of patients at the 3 month follow-up (26% diminished caliber and 2% prolonged transit time).…”

Endovascular Neuromodulation: Safety Profile and Future Directions

“…There is an expanding body of literature on stenting of intracranial venous sinuses for a range of indications (24)(25)(26)(27)(28)(29)(30)(31)(42)(43)(44)(45)(46)(47). This literature exposes the possible risks of intracranial stenting, particularly in-stent thrombosis, and provides strategies for prevention of these complications, namely anticoagulation and antiplatelet therapy.…”

“…Greater experience exists with stenting of the transverse sinuses for the treatment of idiopathic intracranial hypertension (24)(25)(26)(27)(28)(29)(30)(31). According to recent systematic reviews, the overall complication rate associated with this intervention, including minor complications such as wound hematomas or pseudoaneurysms, is 1-7% (24)(25)(26)(27)(28)(29).…”

“…Given the current absence of human trial data on the Stentrode TM , existing literature on structurally comparable devices may provide valuable insights into these risks and their possible preventative strategies. For example, there is a growing number of studies on stent deployment in the intracranial sinuses for a range of indications (24)(25)(26)(27)(28)(29)(30)(31), from which possible stent-related complications of the Stentrode TM may be surmised. Although a transvenous lead has never been previously implanted in the human brain, substantial lessons about the safety and design characteristics of transvenous leads can be taken from the literature on cardiac electrotherapy devices (32)(33)(34)(35)(36).…”