Predictors for venous sinus stent retreatment in patients with idiopathic intracranial hypertension

Mekabaty, Amgad El; Obuchowski, Nancy A.; Luciano, Mark; John, Seby; Chung, Charlotte Y.; Moghekar, Abhay; Jones, Stephen E.; Hui, Ferdinand

doi:10.1136/neurintsurg-2016-012803

Cited by 36 publications

(11 citation statements)

References 34 publications

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“…Focused attention on research to identify the best strategies in patient selection and stent construct (sizing, location) are needed. Identifying risk factors for treatment failure, which at this point are poorly understood,8 9 will help us better counsel patients regarding the risks and benefits of the procedure. Educational courses for those interested in developing an IIH practice could be provided.…”

Section: Discussionmentioning

confidence: 99%

A national survey of venous sinus stenting practices for idiopathic intracranial hypertension

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Kittel

Amans³

et al. 2022

J NeuroIntervent Surg

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BackgroundLittle is currently known about physician opinions and preferences on venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH), practice patterns, or clinical volumes.MethodsA 19 question online survey was designed and distributed to physician members of the Society of Neurointerventional Surgery (SNIS).ResultsA total of 107 individual survey responses were obtained (14% of SNIS members). The majority of respondents (85%) indicated that they had performed at least one VSS procedure independently during their careers. Mean (SD) and median (range) career case volumes were 20.9 (33.8) and 10.0 (0.0–200.0), respectively. On a 1–10 scale, most respondents reported a high level of interest in treating IIH patients with VSS (median 8), a high level of comfort/expertise in treating IIH patients with VSS (median 9), and that VSS was effective in the long term reduction of symptoms and papilledema in IIH patients (median 8). Fifty-nine per cent of respondents reported increasing VSS volumes compared with previous years. A major complication during a VSS procedure, including two deaths, was reported by 11% of respondents.ConclusionsThis is the first study designed to understand the opinions and practices of neurointerventionists regarding VSS for IIH. Overall physician opinion on VSS was quite positive, supported by increasing procedural volumes reported by most over the past few years. However, only a small percentage of respondents had substantial experience with VSS and major complications were not rare.

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Section: Discussionmentioning

confidence: 99%

A national survey of venous sinus stenting practices for idiopathic intracranial hypertension

Fargen

Kittel

Amans³

et al. 2022

J NeuroIntervent Surg

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“…Ahmed et al reported that patients needing retreatment had higher opening lumbar pressures and higher initial pressure gradients 31. Mekabaty et al found that the need for retreatment was correlated with BMI 40. Kumpe et al reported that the need for retreatment was correlated with female gender, younger age, and higher opening lumbar pressures 37.…”

Section: Recommendationsmentioning

confidence: 99%

Recommendations for the selection and treatment of patients with idiopathic intracranial hypertension for venous sinus stenting

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Liu

Garner

et al. 2018

J NeuroIntervent Surg

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“…More than 90% of idiopathic intracranial hypertension (IIH) patients are known to have cerebral venous sinus stenosis (1,2). Based on these findings, venous stenting has become an established treatment option for IIH patients, especially for refractory cases (3,4).…”

Section: Introductionmentioning

confidence: 99%

A Comparison Between Pressure Wire and Microcatheter Measurements for Evaluating the Cerebral Venous Pressure Gradient

et al. 2021

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Introduction: A pressure gradient of over 8 mm Hg across the stenosis (usually located in the transverse-sigmoid junction) is one of the criteria for cerebral venous stenting in idiopathic intracranial hypertension (IIH) patients. The possible inaccuracy of the traditional microcatheter-based pressure measurements has been discussed in previous studies. In the cardiology field, a dual-sensor pressure wire is routinely used for the evaluation of stenotic lesions. Using a pressure wire for cerebral vasculature was previously discussed in a small case series and case reports. In this study, we compared venous pressure measurements obtained using both a microcatheter and a pressure wire in patients who were candidates for stenting.Methods: A retrospective study was conducted, comparing the two methods of pressure measurements in 26 patients with venous stenosis. Altogether, 120 measurements were performed using both methods. Demographic characteristics, medical history, procedural details, medications, indications for the procedure, and complications were collected from the patient charts.Results: Based on an 8-mm Hg pressure gradient cutoff indication, 19 patients were found eligible to go through unilateral venous stenting based on catheter measurements alone. The wire results corroborated the catheter results in detecting all cases indicated for a stent. This finding implies a sensitivity equal to 100% for the wire measurements. There were no wire-related complications, demonstrating its safety.Conclusions: We conclude that the pressure wire is as safe as the microcatheter and can identify cases requiring intervention. A larger-scale study is needed to assess the measurement accuracy of the pressure wire in brain vasculature.

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Predictors for venous sinus stent retreatment in patients with idiopathic intracranial hypertension

Cited by 36 publications

References 34 publications

A national survey of venous sinus stenting practices for idiopathic intracranial hypertension

A national survey of venous sinus stenting practices for idiopathic intracranial hypertension

Recommendations for the selection and treatment of patients with idiopathic intracranial hypertension for venous sinus stenting

A Comparison Between Pressure Wire and Microcatheter Measurements for Evaluating the Cerebral Venous Pressure Gradient

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