Srikanth R Boddu, Pierre Gobin, Cristiano Oliveria, Marc Dinkin, Athos Patsalides
{"title":"Pressure variations in cerebral venous sinuses of idiopathic intracranial hypertension patients.","authors":"Srikanth R Boddu, Pierre Gobin, Cristiano Oliveria, Marc Dinkin, Athos Patsalides","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the alteration of pressure characteristics in the cerebral venous sinuses before and after venous sinus stenting (VSS) using mean sinus pressures (MSPs), sinus pressure gradient (SPG), and sinus pressure pulsatility (SPP) parameters among the idiopathic intracranial hypertension (IIH) patients.</p><p><strong>Materials and methods: </strong>Prospective evaluation of 45 consecutive IIH patients who underwent VSS at our institution. A written informed consent approved by the Weill Cornell Institutional Review Board was signed by the study participants. All patients (<i>n</i> = 45) were evaluated for MSPs and SPG. In a subgroup of 12 (<i>n</i> = 12) consecutive patients, SPP was measured. MSP was measured using microcatheter at superior sagittal sinus (SSS), transverse sinus (TS), and sigmoid sinus (SS). SPG was measured as trans-stenotic gradient and trans-torcular gradient. SPP was recorded in the dominant TS with a six French intermediate catheter. Statistical analysis was performed using paired student <i>t</i>-test and two sample <i>t</i>-tests tested for both equal and unequal variances. <i>P</i> values below 0.05 were considered significant.</p><p><strong>Results: </strong>The mean age of the study population was 30.6 ± 10 years (7-59 years) and 43 out of 45 are female patients. The mean weight and BMI of the study population were 96 ± 24.7 kg (30.8-144 kg) and 35.6 ± 8.3 kg/M<sup>2</sup> (16.4-51.4 kg/M<sup>2</sup>), respectively. VSS in IIH patients resulted in immediate reduction of MSP in the SSS {Δ Mean: -8.1 mm Hg [95% confidence interval (CI): -5.0-11.7 mm Hg], <i>p</i> < 0.001} and TS [Δ Mean: -11.8 mm Hg (95% CI: -7.5 to 13.4 mm Hg), p < 0.001] and increase of MSP in SS [Δ Mean: 7.5 mm Hg (95% CI: 6-10.1 mm Hg), p < 0.001]. Significant reduction of trans-stenotic SPG reduction [Δ Mean: -15.7 mm Hg (95% CI: -13.6-17.8 mm Hg), p < 0.001] and SPP [Δ Mean: -8 mm Hg (95% CI: -2.5-13.4 mm Hg), p < 0.05] was observed following VSS.</p><p><strong>Conclusion: </strong>VSS resulted in immediate alteration of the cerebral venous sinus pressure measurements in patients with IIH.</p>","PeriodicalId":88555,"journal":{"name":"Journal of vascular and interventional neurology","volume":"10 1","pages":"25-30"},"PeriodicalIF":0.0000,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999300/pdf/jvin-10-1-6.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of vascular and interventional neurology","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the alteration of pressure characteristics in the cerebral venous sinuses before and after venous sinus stenting (VSS) using mean sinus pressures (MSPs), sinus pressure gradient (SPG), and sinus pressure pulsatility (SPP) parameters among the idiopathic intracranial hypertension (IIH) patients.
Materials and methods: Prospective evaluation of 45 consecutive IIH patients who underwent VSS at our institution. A written informed consent approved by the Weill Cornell Institutional Review Board was signed by the study participants. All patients (n = 45) were evaluated for MSPs and SPG. In a subgroup of 12 (n = 12) consecutive patients, SPP was measured. MSP was measured using microcatheter at superior sagittal sinus (SSS), transverse sinus (TS), and sigmoid sinus (SS). SPG was measured as trans-stenotic gradient and trans-torcular gradient. SPP was recorded in the dominant TS with a six French intermediate catheter. Statistical analysis was performed using paired student t-test and two sample t-tests tested for both equal and unequal variances. P values below 0.05 were considered significant.
Results: The mean age of the study population was 30.6 ± 10 years (7-59 years) and 43 out of 45 are female patients. The mean weight and BMI of the study population were 96 ± 24.7 kg (30.8-144 kg) and 35.6 ± 8.3 kg/M2 (16.4-51.4 kg/M2), respectively. VSS in IIH patients resulted in immediate reduction of MSP in the SSS {Δ Mean: -8.1 mm Hg [95% confidence interval (CI): -5.0-11.7 mm Hg], p < 0.001} and TS [Δ Mean: -11.8 mm Hg (95% CI: -7.5 to 13.4 mm Hg), p < 0.001] and increase of MSP in SS [Δ Mean: 7.5 mm Hg (95% CI: 6-10.1 mm Hg), p < 0.001]. Significant reduction of trans-stenotic SPG reduction [Δ Mean: -15.7 mm Hg (95% CI: -13.6-17.8 mm Hg), p < 0.001] and SPP [Δ Mean: -8 mm Hg (95% CI: -2.5-13.4 mm Hg), p < 0.05] was observed following VSS.
Conclusion: VSS resulted in immediate alteration of the cerebral venous sinus pressure measurements in patients with IIH.
目的:利用特发性颅内高压(IIH)患者平均窦压(MSPs)、窦压梯度(SPG)和窦压脉动(SPP)参数，评价静脉窦支架植入术(VSS)前后脑静脉窦压力特征的变化。材料和方法:对我院45例连续行VSS的IIH患者进行前瞻性评价。研究参与者签署了一份由威尔康奈尔机构审查委员会批准的书面知情同意书。所有患者(n = 45)均进行MSPs和SPG评估。在连续12例患者的亚组中，测量SPP。采用微导管在上矢状窦(SSS)、横窦(TS)和乙状窦(SS)测量MSP。SPG以跨狭窄梯度和跨圆形梯度测量。在优势TS中使用6法中间导管记录SPP。采用配对学生t检验和两样本t检验进行统计分析，检验方差相等和不相等。P值低于0.05认为显著。结果:研究人群的平均年龄为30.6±10岁(7-59岁)，45例患者中有43例为女性。研究人群的平均体重和BMI分别为96±24.7 kg (30.8-144 kg)和35.6±8.3 kg/M2 (16.4-51.4 kg/M2)。IIH患者的VSS导致SSS的MSP立即降低[Δ平均值:-8.1 mm Hg[95%可信区间(CI): -5.0-11.7 mm Hg]， p < 0.001]和TS [Δ平均值:-11.8 mm Hg (95% CI: -7.5至13.4 mm Hg)， p < 0.001]， SS的MSP增加[Δ平均值:7.5 mm Hg (95% CI: 6-10.1 mm Hg)， p < 0.001]。VSS后，经狭窄的SPG降低[Δ平均:-15.7 mm Hg (95% CI: -13.6-17.8 mm Hg)， p < 0.001]和SPP [Δ平均:-8 mm Hg (95% CI: -2.5-13.4 mm Hg)， p < 0.05]显著降低。结论:VSS可立即改变IIH患者的脑静脉窦压测量。
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