Abstract Details

Title Evaluating Long-term Outcomes of Venous Sinus Stenting in Idiopathic Intracranial Hypertension

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P5 - Poster Session 5 (8:00 AM-9:00 AM)

Poster/Presentation
Number 11-016

Objective To determine long-term benefit and safety of venous sinus stenting (VSS) in idiopathic intracranial hypertension (IIH).

Background IIH is a condition affecting young individuals, predominantly women. Multiple studies have shown that VSS is effective in treating IIH-associated papilledema, but long-term outcomes are not well described.

Design/Methods A single center retrospective chart review was performed for patients with IIH who underwent VSS between May 2015 and October 2021 with >36 months of follow-up. Data were collected pre-VSS and from two time points representing short and long duration measures: (1) within the first 12 months post-VSS, and (2) >36 months post-VSS. We evaluated the presence of headache, pulse-synchronous tinnitus, IIH-related medications, and need for additional procedures. Neuro-ophthalmic exam and testing including optical coherence tomography and visual fields were reviewed for patients at all three time points. VSS-related complications were also noted.

Results Of 81 patients who underwent VSS, 38 (47%) had >36 months follow-up. Median follow-up was 53 months (IQR 46-61). Median papilledema grade pre-VSS was 1 (IQR 0.3-3) with 25 patients (66%) having grade 1 papilledema or worse. At the most recent visit, median papilledema grade was 0 (IQR 0-0.5) and 22 patients (58%) were off all IIH medications. Ten patients (26%) underwent additional procedures after initial VSS, including repeat VSS, bariatric surgery, or ventriculoperitoneal shunt placement for any indication. Four patients (11%) underwent additional procedures for persistent or worsening papilledema. Complications within the first 12 months post-VSS were seen in 3 patients (8%) including pain, post-operative seizure, and femoral hematoma. A single patient (3%) had delayed stent thrombosis (non-occlusive), but no other delayed complications were noted in the cohort.

Conclusions This study offers longitudinal post-VSS follow-up on a relatively large IIH patient cohort. It echoes the findings of earlier smaller studies that VSS can offer a safe treatment option with sustained long-term benefit.

Authors/Disclosures
Sabrina Poonja, MD PRESENTER	Dr. Poonja has nothing to disclose.
Kafayat A. Oyemade, MD	Dr. Oyemade has nothing to disclose.
Timothy T. Xu, MD	Dr. Xu has nothing to disclose.
Waleed Brinjikji, MD	No disclosure on file
Jeremy K. Cutsforth-Gregory, MD, FAAN (Mayo Clinic)	Dr. Cutsforth-Gregory has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Cutsforth-Gregory has received publishing royalties from a publication relating to health care.
Kevin Chodnicki (Mayo Clinic)	Kevin Chodnicki has nothing to disclose.
Deena Tajfirouz, MD	Dr. Tajfirouz has nothing to disclose.
John Chen	John Chen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. John Chen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. John Chen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB.

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