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Venous sinus stenting

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https://www.readbyqxmd.com/read/29095707/long-term-management-and-outcomes-after-repair-of-cerebrospinal-fluid-rhinorrhea-related-to-idiopathic-intracranial-hypertension
#1
Theodore A Schuman, Brent A Senior
PURPOSE OF REVIEW: To identify long-term management strategies and outcomes for the treatment of spontaneous cerebrospinal fluid (CSF) rhinorrhea related to idiopathic intracranial hypertension (IIH). RECENT FINDINGS: Adjuvant treatments following surgical repair of spontaneous CSF leaks are aimed at normalizing intracranial pressure (ICP) to minimize the risk of recurrence. IIH is closely linked to obesity, and growing evidence suggests that weight loss, both through conservative and surgical approaches, is effective at addressing the root cause of this disorder...
October 31, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29067093/stent-retriever-thrombectomy-combined-with-local-thrombolytic-therapy-for-cerebral-venous-sinus-thrombosis-a-case-report
#2
Chengwei Chen, Qiujing Wang, Xifeng Li, Ziming Lu, Jian He, Qinrui Fang, Xunchang Ke, Chuanzhi Duan, Tielin Li
The present study reports the effect of successful treatment of cerebral venous sinus thrombosis (CVST) with stent retriever thrombectomy combined with local thrombolytic therapy. Medical records of 29 patients were retrospectively analyzed following a diagnosis of CVST with magnetic resonance venography (MRV) or digital subtraction angiography (DSA). Systemic anticoagulation was the initial treatment in all patients following admission. In group A, stent retriever thrombectomy combined with local thrombolytic therapy was performed on 14 patients who met the criteria of endovascular therapy...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29017198/aggressive-treatment-of-cerebral-venous-sinus-thrombosis-cvt-with-stent-retrievers-and-local-thrombolysis-why-we-need-a-registry
#3
Christina Maria Kowoll, Hannah Lockau, Franziska Dorn, Christian Dohmen
Purpose Anticoagulation is the first-line therapy for cerebral venous sinus thrombosis (CVT). Endovascular treatment is increasingly applied in patients deteriorating despite anticoagulation with extensive thrombosis or contraindications for anticoagulation. Experience with stent retrievers in CVT is limited. Results We present three cases of severe CVT treated with stent-retrievers, thrombus aspiration and local thrombolysis. In two patients with extensive thrombosis, a partial recanalization was achieved, but only one of them showed significant improvement...
October 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28992723/severe-cerebellar-hemorrhage-following-transverse-sinus-stenting-for-idiopathic-intracranial-hypertension
#4
Pascale Lavoie, Marie-Ève Audet, Jean-Luc Gariepy, Martin Savard, Steve Verreault, Alain Gourdeau, Geneviève Milot, Sylvine Carrondo Cottin
We report a severe adverse event occurring in the course of a cohort study (ISRCTN13784335) aimed at measuring the efficacy and safety of venous stenting in the treatment of patients with medically refractory idiopathic intracranial hypertension (IIH). The patient was a 41-year-old woman who was not overweight, who presented with severe headache, grade 1 bilateral papilledema and transient tinnitus, refractory to medical treatment. Right transverse sinus stenting was successfully performed. Following surgery, the patient's state of consciousness decreased acutely with rapid and progressive loss of brainstem reflex...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28984521/idiopathic-intracranial-hypertension-120-day-clinical-radiological-and-manometric-outcomes-after-stent-insertion-into-the-dural-venous-sinus
#5
Hasan Asif, Claudia L Craven, Almas H Siddiqui, Syed N Shah, Samir A Matloob, Lewis Thorne, Fergus Robertson, Laurence D Watkins, Ahmed K Toma
OBJECTIVE Idiopathic intracranial hypertension (IIH) is commonly associated with venous sinus stenosis. In recent years, transvenous dural venous sinus stent (DVSS) insertion has emerged as a potential therapy for resistant cases. However, there remains considerable uncertainty over the safety and efficacy of this procedure, in particular the incidence of intraprocedural and delayed complications and in the longevity of sinus patency, pressure gradient obliteration, and therapeutic clinical outcome. The aim of this study was to determine clinical, radiological, and manometric outcomes at 3-4 months after DVSS in this treated IIH cohort...
October 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28951386/development-of-an-intracranial-dural-arteriovenous-fistula-after-venous-sinus-stenting-for-idiopathic-intracranial-hypertension
#6
Thomas J Buell, Daniel M Raper, Dale Ding, Ching-Jen Chen, Kenneth C Liu
We report a case in which an intracranial dural arteriovenous fistula (DAVF) developed after endovascular treatment of a patient with idiopathic intracranial hypertension with venous sinus stenting (VSS). The pathogenesis may involve hemodynamic alterations secondary to increased poststenting venous sinus pressure, which may cause new arterial ingrowth into the fistulous sinus wall without capillary interposition. Despite administration of dual antiplatelet therapy, there may also be subclinical cortical vein thrombosis that contributed to DAVF formation...
September 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28944707/combined-use-of-stent-retriever-and-aspiration-thrombectomy-for-cerebral-venous-sinus-thrombosis-involving-the-straight-sinus-a-case-report
#7
Syunsuke Taniguchi, Kei Harada, Masahito Kajihara, Kozo Fukuyama
Cerebral venous sinus thrombosis (CVST) is generally treated with anticoagulation therapy, however, endovascular therapy is considered for refractory cases. A 42-year-old woman presented with a progressive disturbance in consciousness, and diagnosed CVST in the straight sinus (SS). Recanalization of SS was achieved by emergent thrombectomy using aspiration catheter and stent-retriever system, and her level of consciousness improved immediately. The combined use of them aided the removal of the thrombus located in the SS...
December 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28934871/idiopathic-intracranial-hypertension-vision-venous-intervention-versus-shunting-in-iih-for-optic-nerve-disc-swelling-trial-patient-perspective-questionnaire
#8
Arun Chandran, Heinke Pulhorn, Catherine McMahon
INTRODUCTION: Headaches, visual problems and tinnitus are symptoms of Idiopathic Intracranial Hypertension (IIH) which resolve with reduction of CSF pressure. Impaired cranial venous outflow has been implicated in the pathogenesis and there is evidence of good treatment results in IIH using venous sinus stenting. We are currently initiating a multi-centre randomised controlled trial, the VISION study (Venous Intervention versus Shunting in IIH for Optic Disc Swelling) comparing radiological (venous sinus stenting) to surgical intervention (CSF shunting)...
September 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28922875/stent-placement-for-disabling-pulsatile-tinnitus-caused-by-a-lateral-sinus-stenosis-a-retrospective-study
#9
Stéphanie Lenck, Marc-Antoine Labeyrie, Fabrice Vallee, Jean-Pierre Saint-Maurice, Antoine Guillonnet, Anne-Laure Bernat, Pierre Vironneau, Emmanuel Houdart
BACKGROUND: Lateral sinus stenosis is a little-known cause for pulsatile tinnitus (PT). In several small series, stenting has been described as an effective treatment for disabling PT linked with this type of stenosis. OBJECTIVES: To describe the clinical, radiological, and manometric characteristics of patients treated for disabling PT by lateral sinus stenosis. Assessment of the efficacy of stenting for this indication. METHODS: Retrospective study of patients treated for isolated PT by stenting of a lateral sinus stenosis in our institution, between 2009 and 2015...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28858988/venous-diverticula-causing-pulsatile-tinnitus-treated-with-coil-embolization-and-stent-placement-with-resolution-of-symptoms-report-of-two-cases-and-review-of-the-literature
#10
Ravi K Shastri, Neeraj Chaudhary, Aditya S Pandey, Steven A Telian, Joseph J Gemmete
OBJECTIVE: To report two cases of pulsatile tinnitus caused by complex venous diverticula with successful treatment via coil embolization and stent placement followed by complete resolution of symptoms. We also review the literature pertaining to venous diverticula causing pulsatile tinnitus treated using endovascular techniques. PATIENTS: Two women patients, aged 27 and 29 years, presented to our institution with 3-month histories of pulsatile tinnitus. In each case, non-invasive imaging and conventional digital subtraction angiography (DSA) confirmed the presence of a complex right transverse-sigmoid sinus junction diverticulum...
October 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28841117/transient-resolution-of-venous-sinus-stenosis-after-high-volume-lumbar-puncture-in-a-patient-with-idiopathic-intracranial-hypertension
#11
Thomas J Buell, Daniel M S Raper, I Jonathan Pomeraniec, Dale Ding, Ching-Jen Chen, Davis G Taylor, Kenneth C Liu
Stenosis of the transverse sinus (TS) and sigmoid sinus (SS), with a trans-stenosis pressure gradient, has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH). MRI has shown improvement in TS and SS stenosis after high-volume lumbar puncture (HVLP) in a subset of patients with IIH. The authors present the first report of an IIH patient with immediate post-HVLP TS and SS trans-stenosis pressure gradient reduction and an attendant increase in TS and SS cross-sectional area confirmed using intravascular ultrasonography (IVUS)...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28710082/accuracy-and-precision-of-venous-pressure-measurements-of-endovascular-microcatheters-in-the-setting-of-dural-venous-sinus-stenosis
#12
Michael B Avery, Sheryl Sambrano, Javed Khader Eliyas, Muneer Eesa, Alim P Mitha
INTRODUCTION: Dural venous sinus stenosis (DVSS) may lead to increased intracranial pressure, sometimes requiring a stent if a high pressure gradient exists. Many neuroendovascular physicians use microcatheters to measure gradients, yet there are no studies comparing the accuracies and precisions of modern day microcatheters. We examined pressure recordings from five commonly used microcatheters in an experimental DVSS model. METHODS: Using a programmable pump, dynamic flow was established in a closed circuit mimicking the venous sinus waveform...
July 14, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28698087/computational-fluid-dynamics-simulation-of-hemodynamic-alterations-in-sigmoid-sinus-diverticulum-and-ipsilateral-upstream-sinus-stenosis-after-stent-implantation-in-patients-with-pulsatile-tinnitus
#13
Yanjing Han, Qingqing Yang, Zeran Yang, Jun Xia, Tianhao Su, Jianan Yu, Long Jin, Aike Qiao
OBJECTIVE: To investigate the relationships between upstream venous sinus stenosis and pulsatile tinnitus (PT), and to assess the correlation with diverticulum growth and the effectiveness of stent implantation. METHODS: Patient-specific geometric models were constructed using computed tomography venography images from a patient with PT, with sigmoid sinus diverticulum, and with upstream transverse sinus stenosis, in whom stenting of the upstream sinus stenosis alone achieved complete remission of PT...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645586/venous-sinus-stenting-in-the-management-of-patients-with-intracranial-hypertension-manifesting-with-skull-base-cerebrospinal-fluid-leaks
#14
Rajiv R Iyer, David Solomon, Abhay Moghekar, C Rory Goodwin, C Matthew Stewart, Masaru Ishii, Philippe Gailloud, Gary L Gallia
BACKGROUND: A subset of patients with skull base cerebrospinal fluid (CSF) leaks are found to have elevated intracranial pressure (ICP). In these patients, elevated ICP is thought to contribute to both the pathophysiology of the leak and postoperative leak recurrences. Current strategies for postoperative ICP control include medical therapy and shunting procedures. The aim of this study is to report the use of venous sinus stenting (VSS) in the management of patients with skull base CSF leaks caused by elevated ICP...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28637822/pattern-of-pressure-gradient-alterations-after-venous-sinus-stenting-for-idiopathic-intracranial-hypertension-predicts-stent-adjacent-stenosis-a-proposed-classification-system
#15
Daniel Raper, Thomas J Buell, Dale Ding, Ching-Jen Chen, Robert M Starke, Kenneth C Liu
OBJECTIVE: Venous sinus stenting (VSS) is a safe and effective treatment for idiopathic intracranial hypertension (IIH) with angiographic venous sinus stenosis. However, predictors of stent-adjacent stenosis (SAS) remain poorly defined. METHODS: We performed a retrospective review of 47 patients with IIH and intracranial venous stenosis who underwent VSS with pre- and post-stent venography. Patient characteristics, treatments and outcomes were reviewed. Changes in pressure gradient after VSS were classified according to pattern of gradient resolution into types I-III...
June 21, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28560487/effect-of-venous-stenting-on-intracranial-pressure-in-idiopathic-intracranial-hypertension
#16
Samir A Matloob, Ahmed K Toma, Simon D Thompson, Chee L Gan, Fergus Robertson, Lewis Thorne, Laurence D Watkins
BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterised by an increased intracranial pressure (ICP) in the absence of any central nervous system disease or structural abnormality and by normal CSF composition. Management becomes complicated once surgical intervention is required. Venous sinus stenosis has been suggested as a possible aetiology for IIH. Venous sinus stenting has emerged as a possible interventional option. Evidence for venous sinus stenting is based on elimination of the venous pressure gradient and clinical response...
May 31, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28515755/common-origin-of-all-three-coronary-arteries-from-the-right-sinus-of-valsalva-first-case-study-accompanied-by-mitral-valve-prolapse-and-vein-anomaly-second-case-study-followed-by-successful-percutaneous-coronary-intervention-of-right-coronary-artery-stenosis
#17
Brygida Przywara-Chowaniec, Agata Puzio, Łukasz Czarnecki, Damian Kawecki, Jan Głowacki, Ewa Nowalany-Kozielska, Aleksandra Czarnecka
Congenital anomalies of the coronary arteries can be divided into two broad categories: those that alter myocardial perfusion and those that do not. In coronary anomalies not altering myocardial perfusion, the coronary arteries originate from the aorta, but their origins are in unusual positions. Although myocardial perfusion is normal, the angiographer may have trouble locating them. Patients with an anomalous left main coronary artery arising from the right sinus of Valsalva are presented. The diagnosis was made by coronary angiography, transesophageal echocardiography and multislice computed tomography (MSCT)...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28487359/venous-sinus-stenting-shortens-the-duration-of-medical-therapy-for-increased-intracranial-pressure-secondary-to-venous-sinus-stenosis
#18
Tarek A Shazly, Ashutosh P Jadhav, Amin Aghaebrahim, Andrew F Ducruet, Brian T Jankowitz, Tudor G Jovin, Gabrielle R Bonhomme
INTRODUCTION: Medical treatment, cerebrospinal fluid (CSF) shunting, and optic nerve sheath fenestration are standard treatments for increased intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH). Venous sinus stenting provides a novel alternative surgical treatment in cases of venous sinus stenosis with elevated ICP. METHODS: 12 consecutive subjects with papilledema, increased ICP, and radiological signs of dural sinus stenosis underwent cerebral venography and manometry...
May 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28452616/an-ovine-model-of-cerebral-catheter-venography-for-implantation-of-an-endovascular-neural-interface
#19
Thomas James Oxley, Nicholas Lachlan Opie, Gil Simon Rind, Kishan Liyanage, Sam Emmanuel John, Stephen Ronayne, Alan James McDonald, Anthony Dornom, Timothy John Haynes Lovell, Peter John Mitchell, Iwan Bennett, Sebastien Bauquier, Leon Norris Warne, Chris Steward, David Bruce Grayden, Patricia Desmond, Stephen M Davis, Terence John O'Brien, Clive N May
OBJECTIVE Neural interface technology may enable the development of novel therapies to treat neurological conditions, including motor prostheses for spinal cord injury. Intracranial neural interfaces currently require a craniotomy to achieve implantation and may result in chronic tissue inflammation. Novel approaches are required that achieve less invasive implantation methods while maintaining high spatial resolution. An endovascular stent electrode array avoids direct brain trauma and is able to record electrocorticography in local cortical tissue from within the venous vasculature...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28431144/effect-of-body-mass-index-on-venous-sinus-pressures-in-idiopathic-intracranial-hypertension-patients-before-and-after-endovascular-stenting
#20
Daniel M S Raper, Dale Ding, Thomas J Buell, R Webster Crowley, Robert M Starke, Kenneth C Liu
BACKGROUND: Elevated body mass index (BMI) has been correlated with worse outcomes after treatment for idiopathic intracranial hypertension (IIH). Venous sinus stenting (VSS) has emerged as a safe and effective treatment for a subset of patients with IIH and evidence of venous sinus stenosis. However, the association between BMI and the efficacy of VSS remains poorly characterized. OBJECTIVE: To determine, in a retrospective cohort study, the effect of BMI on preoperative mean intracranial venous pressure (MVP) and post-VSS outcomes...
April 20, 2017: Neurosurgery
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