Venous sinus manometry and intervention using the PrimeWire Prestige pressure guidewire: technique and initial experience

Lopes, Demetrius K.; Johnson, Andrew K.; Tan, Lee A.

doi:10.1136/neurintsurg-2012-010439

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Using our technique, there were no wire-related complications. Other studies also support the safety of using a pressure wire in the cerebral venous system (10,11,15,16). We also noticed that the wire was in full agreement with the microcatheter system on patients with pressure gradients equal to or >8 mm Hg, which is currently the formal indication for venous stenting (100% sensitivity).…”

Section: Discussionsupporting

confidence: 74%

“…Dual-sensor pressure wires have been routinely used for over 20 years in the cardiology field for gradient measurement over stenotic lesions (13). Over the past 10 years, only a few case reports and case series have studied the safety and possible accuracy of using a pressure wire for measurements of brain vasculature (10,11,(14)(15)(16). Since doubts exist regarding the accuracy of catheter-based venous measurement, we decided, in our medical center, to perform both catheter and pressure wire measurements in all cases before making the decision to deploy a stent in the venous system.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 74%

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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“…35 The PrimeWire Prestige pressure guide wire system provided a safe and effective method for intracranial venous sinus manometry. 10 The present study demonstrated moderate differences between venous manometry obtained by the microcatheter and pressure wire, especially in terms of trans-stenosis pressure gradients and pressure of the proximal stenosis. Overall, venous pressure measurements were higher when obtained by the microcatheter, but MVPs in the torcula and pressure of the distal stenosis were similar between venous manometry measured with the microcatheter and pressure wire.…”

Section: Discussionmentioning

confidence: 47%

“…35 The PrimeWire Prestige pressure guide wire system provided a safe and effective method for intracranial venous sinus manometry. 10…”

Section: Discussionmentioning

confidence: 99%

“…The PrimeWire Prestige pressure guide wire system provides a safe, quick and effective method for venous sinus manometry and intervention. 10 However, little is known about the effect of venous manometric method on venous sinus pressure measurements. The purpose of this study was to compare the venous sinus pressures measured by microcatheter and by pressure wire before VSS, and to select the most suitable venous sinus manometric tool.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of microcatheter and pressure wire for venous sinus manometric evaluation of patients with idiopathic intracranial hypertension

Wang

Tong

et al. 2022

Interv Neuroradiol

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Background Venous sinus manometry performed by microcatheter to assess candidacy for venous sinus stenting in patients with idiopathic cranial pressure (IIH) can be tiring, time-consuming and unreliable. Pressure wire is widely used to measure coronary pressure and evaluate coronary stenosis severity, but venous sinus manometry using the pressure guide wire has only been reported in one case, and few studies have examined the accuracy of this approach. Objective To compare venous manometry performed by microcatheter with by pressure wire under awake setting in patients with IIH. Methods The manometry results of 30 patients with IIH were recorded by Rebar-27 microcatheter and a pressure wire under awake setting. The mean venous pressures (MVPs) and trans-stenosis pressure gradients were obtained and compared between microcatheter and pressure wire. Paired t-test) were used to evaluate the data between the two groups. Results MVPs in superior sagittal sinus (SSS) and torcula were slightly higher with microcatheter, though without statistically significant differences (p > 0.05). MVPs in transverse sinus (TS) and sigmoid sinus (SS) were significantly higher with microcatheter (p < 0.05). Trans-stenotic pressure gradient with microcatheter was significantly higher than with pressure wire (p＜0.001). Conclusions Intracranial venous pressure measured with the microcatheter and pressure wire showed a moderate difference. Compared with the traditional microcatheter method，the pressure wire is safe, fast and effective method to identify the patient needing intervention.

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Dural venous sinus stenting technique for idiopathic intracranial hypertension in patients with tortuous venous anatomy

et al. 2023

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Venous sinus stenting (VSS) for medically refractory idiopathic intracranial hypertension (IIH) is emerging as a safe and effective alternative to shunting. However, stent navigation past the jugular bulb with commonly used carotid stenting systems via femoral access in cases with tortuous venous anatomy can present a challenge, leading to procedural failure. We present a technical re nement using a cervical access and peripheral vascular stent with a more stable 0.035-inch delivery platform as an alternative to the traditional approach to simplify the procedure and overcome the technical di culties in cases with tortuous venous anatomy. Our institutional database for patients who had IIH and undergone VSS using the peripheral vascular stent between 2013 and 2023 was retrospectively reviewed. Data on 36 patients (33 women, 3 men, mean age 32 years) was collected. VSS was technically successful in all patients (100%) without major complications or thrombosis. There was one case of minor neck cellulitis treated with oral antibiotics. Three patients underwent repeat stenting, and 2 patients had ventriculoperitoneal shunt placement after stenting due to persistent or recurrent symptoms. All patients (100%) had improvement or resolution of papilledema; however, six patients had evidence of optic atrophy and persistent vision loss. Headache was resolved or improved in 91% of patients. In the presence of tortuous venous anatomy, VSS using cervical access and a peripheral vascular stent with a more stable 0.035-inch delivery platform can be considered as a safe and effective alternative approach with shorter procedure time. This approach is particularly advantageous in situations where the procedure is prolonged or high dose of contrast has been administered due to the technical challenges associated with the traditional use of carotid systems via femoral access for stent delivery.

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Venous sinus manometry and intervention using the PrimeWire Prestige pressure guidewire: technique and initial experience

Abstract: The PrimeWire Prestige pressure guidewire system provided a safe, fast and effective method for intracranial venous sinus manometry and intervention. It has several potential advantages over the traditional microcatheter method, including efficiency, accuracy and cost.

Cited by 5 publications

References 7 publications

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

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

Comparison of microcatheter and pressure wire for venous sinus manometric evaluation of patients with idiopathic intracranial hypertension

Dural venous sinus stenting technique for idiopathic intracranial hypertension in patients with tortuous venous anatomy

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