A82 Venous sinus stenting in idiopathic intracranial hypertension: clinical outcomes from a single-center experience
Year: 2026
Type: conference-abstract
Abstract: Background/Introduction Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without an identifiable cause. It predominantly affects women of childbearing age with elevated BMI. Common symptoms include headache, tinnitus, and visual disturbances, potentially progressing to blindness. Among proposed mechanisms, dural venous sinus stenosis may impair cerebral venous outflow, increasing venous pressure and disrupting cerebrospinal fluid absorption. Objective/Purpose To retrospectively evaluate clinical outcomes in patients with IIH treated with venous sinus stenting (VSS) at our center between 2022 and 2024. Methods/Case Description Twelve patients (9 females, 3 males; mean age 42 years) diagnosed with IIH according to modified Dandy criteria underwent VSS. Inclusion criteria were refractoriness or intolerance to medical therapy or rapidly worsening vision, with ≥50% venous sinus stenosis on MRI and a trans-stenotic pressure gradient ≥6 mmHg confirmed by venous manometry. Stenting was performed under general anesthesia with post-procedural confirmation of gradient normalization. Dual antiplatelet therapy was administered for 6 months, followed by single therapy for an additional 6 months. Clinical and radiological follow-up was conducted at 6 and 12 months. Results/Findings A total of 12 self-expanding stents were deployed (100% technical success), mainly at the transverse–sigmoid sinus junction. Adjunctive balloon angioplasty was required in 50% of cases. At 1 year, 91.6% of patients showed significant improvement in papilledema, and 90% reported headache resolution or improvement. Tinnitus resolved completely in 83.3% of affected patients. All patients experienced improvement in visual symptoms. No major peri-procedural complications, strokes, hemorrhages, or restenosis were observed. Transient post-procedural headache occurred in 25% of patients and resolved within 3 days. Discussion/Conclusions/Learning Points Our findings align with current literature, confirming VSS as a safe and effective option for refractory IIH. Compared to traditional surgical approaches, VSS demonstrates favorable efficacy and lower complication rates. Larger prospective studies with longer follow-up are needed to refine patient selection and assess long-term outcomes.
Institution: Azienda Ospedaliera Ospedale San Carlo Borromeo
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7205016286