Feasibility and Efficacy of Venous Sinus Stenting for Idiopathic Intracranial Hypertension in a non-Western Country.

Abstract

Background and purpose: Most patients with idiopathic intracranial hypertension (IIH) have venous sinus stenosis. In the previous decade, venous sinus stenting has emerged as an ultimate treatment for resistant or refractory cases with IIH. However, studies in this regard are relatively few, especially from lower income countries. We aimed to evaluate the feasibility and efficacy of venous sinus stenting in our tertiary center.

Methods: We retrospectively reviewed our prospectively collected database from January 2021 to January 2023 and recruited eligible patients with IIH and venous sinus stenosis who underwent stenting.

Results: We recruited 113 patients, all of them were females with a mean age of 30 ± 8 years and mean BMI of 30 ± 3.1. Stenting was technically successful in all our patients. Post stenting angioplasty was warranted in three cases (2.6%). Complications occurred in one case (0.9%) in the form of a rim of subdural hematoma without any clinical sequelae. At 3 months follow-up, 93 patients (82.3%) experienced complete relief of their symptoms, whereas 11 patients (9.7%) still had headache without papilledema and 9 patients (8%) had papilledema. Seven patients (6.2%) received ventriculoperitoneal shunting and two patients (1.8%) experienced restenosis and received another stenting procedure.

Conclusions: Stenting of the venous sinus stenosis in IIH patients is effective and safe treatment and can be accomplished with a very low complication rate and relatively higher success rate.