E-065 Transverse venous sinus stenting for idiopathic intracranial hypertension – a single centre experience

Abstract

PurposeTransverse sinus stenosis is commonly seen in patients with idiopathic intracranial hypertension (IIHT). It is not clear whether it is the cause or the result of IIHT. Stenting for IIHT has been done in several prior series. Our goal was to evaluate the clinical and imaging follow up results of patients with IIHT that underwent stenting for this condition at our Centre.Materials and MethodsWe reviewed the clinical, venographic and follow up imaging and imaging data in patients who underwent elective transverse sinus stenting during the period from 2011 to 2016.ResultsSeven patients with IIHT were identified, of which one had associated dural AVF and hence was excluded from the study. The mean lumbar CSF opening pressure recorded was 370 mm of H20. At venography, the mean pressure gradient across the dominant transverse sinus stenosis was 17 mm of Hg (range of 10–23 mm of Hg). The pressure gradient immediately after stenting in all of those measured was negligible. Following stenting, headache improved in 3 of the 6 cases, with persistent headache in 2, of which one had persistent baseline migraine. One patient had complete relief of their headache. All cases showed no papilledema on follow up. Follow up imaging with CT venography showed that the stents remained widely patent. Follow-up in clinic was done for a mean period of 35.5 months (range 4 months to 65 months). Follow up with CT venography was done for a mean of 10.3 months (range 2 months to 36 months). Time to stenting was done with a mean of 4.6 months (2 months to 9 months).ConclusionVenous sinus stenting is a safe procedure. It helps to relieve papilledema in all cases with significant improvement of headaches in most cases.Disclosures J. Kovoor: None. J. Tejada: None. K. Riley: None. R. Shastri: None.