TY - JOUR
T1 - Venous sinus stenting for idiopathic intracranial hypertension
T2 - An updated Meta-analysis
AU - Azzam, Ahmed Y.
AU - Mortezaei, Ali
AU - Morsy, Mahmoud M.
AU - Essibayi, Muhammed Amir
AU - Ghozy, Sherief
AU - Elamin, Osman
AU - Azab, Mohammed A.
AU - Elswedy, Adam
AU - Altschul, David
AU - Kadirvel, Ramanathan
AU - Brinjikji, Waleed
AU - Kallmes, David F.
N1 - Publisher Copyright:
© 2024
PY - 2024/4/15
Y1 - 2024/4/15
N2 - Background: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure and primarily affects obese women of reproductive age. Venous sinus stenting (VSS) is a surgical procedure used to treat IIH, but its safety and efficacy are still controversial. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Multiple databases were searched for studies evaluating the safety and efficacy of VSS in IIH patients and meta-analysis was performed to pool the data. Results: A total of 36 studies involving 1066 patients who underwent VSS were included. After VSS, a significant reduction in trans-stenotic gradient pressure was observed. Patients also showed significantly lower cerebrospinal fluid (CSF) opening pressure. Clinical outcomes demonstrated improvement in tinnitus (95%), papilledema (89%), visual disturbances (88%), and headache (79%). However, 13.7% of patients experienced treatment failure or complications. The treatment failure rate was 8.35%, characterized by worsening symptoms and recurrence of IIH. The complications rate was 5.35%, including subdural hemorrhage, urinary tract infection, stent thrombus formation, and others. Conclusion: VSS appears to be a safe and effective treatment option for IIH patients who are unresponsive to medical therapy or have significant visual symptoms. However, long-term outcomes and safety of the procedure require further investigation.
AB - Background: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure and primarily affects obese women of reproductive age. Venous sinus stenting (VSS) is a surgical procedure used to treat IIH, but its safety and efficacy are still controversial. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Multiple databases were searched for studies evaluating the safety and efficacy of VSS in IIH patients and meta-analysis was performed to pool the data. Results: A total of 36 studies involving 1066 patients who underwent VSS were included. After VSS, a significant reduction in trans-stenotic gradient pressure was observed. Patients also showed significantly lower cerebrospinal fluid (CSF) opening pressure. Clinical outcomes demonstrated improvement in tinnitus (95%), papilledema (89%), visual disturbances (88%), and headache (79%). However, 13.7% of patients experienced treatment failure or complications. The treatment failure rate was 8.35%, characterized by worsening symptoms and recurrence of IIH. The complications rate was 5.35%, including subdural hemorrhage, urinary tract infection, stent thrombus formation, and others. Conclusion: VSS appears to be a safe and effective treatment option for IIH patients who are unresponsive to medical therapy or have significant visual symptoms. However, long-term outcomes and safety of the procedure require further investigation.
KW - Idiopathic intracranial hypertension
KW - Meta-analysis
KW - Systematic review
KW - Venous sinus stenting
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U2 - 10.1016/j.jns.2024.122948
DO - 10.1016/j.jns.2024.122948
M3 - Article
AN - SCOPUS:85186985430
SN - 0022-510X
VL - 459
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
M1 - 122948
ER -