Efficacy of stenting in patients with cerebral venous sinus thrombosis-related cerebral venous sinus stenosis.


Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 26 08 2018
revised: 05 10 2018
accepted: 08 10 2018
pubmed: 6 11 2018
medline: 10 4 2019
entrez: 4 11 2018
Statut: ppublish

Résumé

Venous stenting has been proven to be a safe and effective therapeutic option for patients with idiopathic intracranial hypertension (IIH) and cerebral venous sinus stenosis (CVSS). However, its use in patients with cerebral venous sinus thrombosis-related CVSS has been less reported. To explore the safety and efficacy of stenting for patients with cerebral venous sinus thrombosis (CVST)-related CVSS. The clinical presentation, treatment, and outcome of patients with CVST-related CVSS received venous stenting in the chronic stage after failed medical treatment were retrospectively evaluated. A total of 17 patients with CVST-related CVSS were included. Mean pressure gradient across the CVSS decreased from 11.5±4.2 mmHg prior to stenting to 2.1±1.1 mmHg post- stenting. Mean CSF opening pressure decreased from 33.1±5.5 cmH Restoring the patency of stenotic sinuses with stents in patients of CVST-related CVSS unresponsive to medical therapy in the chronic stage may improve symptoms in the majority of the patients. However, a relatively higher cerebral hemorrhage rate was observed and may be related to this pathology. Stenting in this subgroup of CVSS patients may require further evaluation with a larger and long-term study, and should be used with caution at this time.

Sections du résumé

BACKGROUND BACKGROUND
Venous stenting has been proven to be a safe and effective therapeutic option for patients with idiopathic intracranial hypertension (IIH) and cerebral venous sinus stenosis (CVSS). However, its use in patients with cerebral venous sinus thrombosis-related CVSS has been less reported.
PURPOSE OBJECTIVE
To explore the safety and efficacy of stenting for patients with cerebral venous sinus thrombosis (CVST)-related CVSS.
METHODS METHODS
The clinical presentation, treatment, and outcome of patients with CVST-related CVSS received venous stenting in the chronic stage after failed medical treatment were retrospectively evaluated.
RESULTS RESULTS
A total of 17 patients with CVST-related CVSS were included. Mean pressure gradient across the CVSS decreased from 11.5±4.2 mmHg prior to stenting to 2.1±1.1 mmHg post- stenting. Mean CSF opening pressure decreased from 33.1±5.5 cmH
CONCLUSION CONCLUSIONS
Restoring the patency of stenotic sinuses with stents in patients of CVST-related CVSS unresponsive to medical therapy in the chronic stage may improve symptoms in the majority of the patients. However, a relatively higher cerebral hemorrhage rate was observed and may be related to this pathology. Stenting in this subgroup of CVSS patients may require further evaluation with a larger and long-term study, and should be used with caution at this time.

Identifiants

pubmed: 30389898
pii: neurintsurg-2018-014328
doi: 10.1136/neurintsurg-2018-014328
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

307-312

Informations de copyright

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Ke Li (K)

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Interventional Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

Ming Ren (M)

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Ran Meng (R)

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Yuchuan Ding (Y)

Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA.

Gary B Rajah (GB)

Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA.

Feng Wang (F)

Department of Interventional Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.

Xunming Ji (X)

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

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