title: Long-term patency of venous sinus stents for idiopathic intracranial hypertension.
abstract: BACKGROUND
  Recent reports suggest that placement of a venous sinus stent improves symptoms in selected patients with idiopathic intracranial hypertension (IIH). We report our evaluation of the long-term patency of venous stents placed for IIH.
  
  
  METHODS
  We retrospectively reviewed our clinical database for 30 patients (mean age 33±10 years) with IIH who underwent placement of 36 venous sinus stents between October 2006 and December 2012. Relevant clinical, demographic and radiographic data were extracted after review of these records. All patients underwent retrograde venography to confirm a >50% stenosis and a trans-stenosis pressure gradient. Follow-up catheter angiography was performed beginning 3 months after the procedure.
  
  
  RESULTS
  Follow-up imaging was available for 23 (77%) of the 30 patients (mean 23 months). For seven patients, angiographic follow-up of >2 years (mean 45 months) was available. All stents remained patent with mild (<25%) in-stent stenosis observed in four patients. In five patients, however, we observed a narrowing of the sinus proximal to the stent. Although no patient underwent repeat stent placement for persistent or recurrent symptoms, cerebrospinal fluid diversion was performed in five cases.
  
  
  CONCLUSIONS
  Venous sinus stent placement has emerged as a promising treatment option for the subgroup of patients with IIH with a pressure gradient across a stenotic venous sinus. We observed long-term patency of all stents placed in this patient population. Further prospective investigation is necessary to improve our understanding of the phenomenon of sinus narrowing upstream of a patent stent and to establish definitively the long-term clinical efficacy of venous sinus stent placement for IIH.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Ducruet
authors.forename: R Webster
authors.initials: RW
authors.lastname: Crowley
authors.forename: Cameron G
authors.initials: CG
authors.lastname: McDougall
authors.forename: Felipe C
authors.initials: FC
authors.lastname: Albuquerque
mesh_terms: D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging* / Q000209:etiology; D003392:Cranial Sinuses / Q000000981:diagnostic imaging; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011559:Pseudotumor Cerebri / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Intervention; Intracranial Pressure; Stenosis; Stent; Vein