Clinical Outcomes and Predictors of Precise Stent Placement in Patients with Isolated Pulsatile Tinnitus.

Purpose: There is no dedicated stent for isolated venous pulsatile tinnitus (IVPT). This retrospective study aimed to evaluate the the clinical outcomes and associated factors of Precise stent (Cordis) implantation in the management of IVPT.

Methods: We analyzed data from IVPT patients treated at our center between December 2009 and August 2024. Baseline characteristics, venous sinus morphology, endovascular techniques, clinical outcomes, and follow-up data were reviewed.

Results: Among 111 IVPT patients, 64 (57.7%) underwent cranial venous sinus stenting (CVSS) using the Precise stent, with 59 (92.2%) being women. IVPT resolved immediately after CVSS in all cases. Over a mean follow-up of 90.9 ± 42.7 months, 18 patients (28.1%) experienced postoperative headaches, all female, with 61.1% reporting symptoms within the first week. Headaches had a mean duration of 44.9 ± 70.5 days and an average visual analog scale score of 3.4 ± 1.5, with 94.5% described as pressure-like. Younger age was significantly associated with headache occurrence (P < 0.05), while other factors, including stent size and operation time, showed no correlation.

Conclusion: Precise stent implantation in venous sinus is highly effective for treating IVPT, but postoperative headaches, particularly in younger women, are a common complication. Further research is needed to mitigate these side effects and enhance long-term patient outcomes.