A national survey of venous sinus stenting practices for idiopathic intracranial hypertension

J Neurointerv Surg. 2023 May;15(5):507-511. doi: 10.1136/neurintsurg-2022-018832. Epub 2022 Apr 15.

Abstract

Background: Little is currently known about physician opinions and preferences on venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH), practice patterns, or clinical volumes.

Methods: A 19 question online survey was designed and distributed to physician members of the Society of Neurointerventional Surgery (SNIS).

Results: A total of 107 individual survey responses were obtained (14% of SNIS members). The majority of respondents (85%) indicated that they had performed at least one VSS procedure independently during their careers. Mean (SD) and median (range) career case volumes were 20.9 (33.8) and 10.0 (0.0-200.0), respectively. On a 1-10 scale, most respondents reported a high level of interest in treating IIH patients with VSS (median 8), a high level of comfort/expertise in treating IIH patients with VSS (median 9), and that VSS was effective in the long term reduction of symptoms and papilledema in IIH patients (median 8). Fifty-nine per cent of respondents reported increasing VSS volumes compared with previous years. A major complication during a VSS procedure, including two deaths, was reported by 11% of respondents.

Conclusions: This is the first study designed to understand the opinions and practices of neurointerventionists regarding VSS for IIH. Overall physician opinion on VSS was quite positive, supported by increasing procedural volumes reported by most over the past few years. However, only a small percentage of respondents had substantial experience with VSS and major complications were not rare.

Keywords: Intervention; Intracranial Pressure; Stenosis; Stent; Vein.

MeSH terms

  • Cranial Sinuses / diagnostic imaging
  • Cranial Sinuses / surgery
  • Humans
  • Intracranial Hypertension*
  • Papilledema*
  • Pseudotumor Cerebri*
  • Retrospective Studies
  • Stents / adverse effects
  • Treatment Outcome