Title:Long-term Outcomes of Cerebral Venous Sinus Stenosis Corrected by Stenting
Volume: 16
Issue: 1
Author(s): Yaoming Xu, Ran Meng, Gary B. Rajah, Yuchuan Ding, Yan Wu, Yali Wu, Kangxiang Ji, Chuanjie Wu, Wenbo Zhao and Xunming Ji*
Affiliation:
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing,China
Keywords:
Cerebral Venous Sinus Stenosis (CVSS), stenting, long-term outcome, Intracranial Hypertension (IH), therapy,
papilledema.
Abstract:
Background and Purpose: Cerebral Venous Sinus Stenosis (CVSS) usually results in
severe Intracranial Hypertension (IH), which can be corrected by stenting immediately. However,
there is a lack of evidence of the long-term good outcomes in patients with CVSS who underwent
stenting.
Methods: A total of 62 patients with imaging confirmed non-thrombotic and non-external compression
CVSS were enrolled into this single center real-world cohort study after undergoing stenting,
and were continuously followed up for more than 12 years. The symptoms and signs of IH
prior to stenting and post-stenting and the incidence of restenosis after stenting were analyzed.
Results: The mean age of the 62 patients (range, 13 to 62) was 40 years old, and the mean body
mass index was 26 (range 23 to 40). Females accounted for 67.7% (42/62). Headache was the most
common symptom (79%). Transient visual obscurations occurred in 69% of the patients. 42% of
the patients suffered from visual loss, 11.3% pulsatile tinnitus, and 96.8% Papilledema before
stenting. The mean trans-stenotic pressure gradients were 6~43 mmHg prior to stenting and returned
to 0~4 mmHg after stent placement. During the following 12~126 months (the median was
62) after stenting of the follow-up, 91.9% (57/62) of the patients obtained good outcomes. Headaches
disappeared in 96% (47/49) of the patients and papilledema was attenuated in 98.3%
(59/60). However, There were still 8.0 % (5/62) of the patients with poor outcomes, including optic
disc atrophy in 3 patients and stent-interior thrombosis in 2 patients, which occurred 6.3 months
after stenting.
Conclusion: Our data suggest that stenting may be a promising therapy for CVSS correcting. Patients
with CVSS may get long-term benefit from stenting, especially when they are accompanied
with severe IH.
