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  1. Article ; Online: Future Directions and Innovations in Venous Sinus Stenting.

    Pandey, Abhinav / Schreiber, Craig / Garton, Andrew L A / Jung, Brandon / Goldberg, Jacob L / Kocharian, Gary / Carnevale, Joseph A / Boddu, Srikanth R

    World neurosurgery

    2024  Volume 184, Page(s) 387–394

    Abstract: This review explores the future role of venous sinus stenting (VSS) in the management of idiopathic intracranial hypertension and pulsatile tinnitus. Despite its favorable safety profile and clinical outcomes compared with traditional treatments, VSS is ... ...

    Abstract This review explores the future role of venous sinus stenting (VSS) in the management of idiopathic intracranial hypertension and pulsatile tinnitus. Despite its favorable safety profile and clinical outcomes compared with traditional treatments, VSS is not yet the standard of care for these conditions, lacking high-level evidence data and guidelines for patient selection and indications. Current and recently completed clinical trials are expected to provide data to support the adoption of VSS as a primary treatment option. Additionally, VSS shows potential in treating other conditions, such as dural arteriovenous fistula and cerebral venous sinus thrombosis, and it is likely that the procedure will continue to see an expansion of its approved indications. The current lack of dedicated venous stenting technology is being addressed with promising advancements, which may improve procedural ease and patient outcomes. VSS also offers potential for expansion into modulation of brain electrophysiology via endovascular routes, offering exciting possibilities for neurodiagnostics and treatment of neurodegenerative disorders.
    MeSH term(s) Humans ; Treatment Outcome ; Pseudotumor Cerebri ; Stents ; Cranial Sinuses/surgery ; Endovascular Procedures/methods ; Intracranial Hypertension ; Retrospective Studies
    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2023.12.128
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Challenges in the use of Venous Sinus Stenting in the Treatment of Idiopathic Intracranial Hypertension and Pulsatile Tinnitus.

    Pandey, Abhinav / Schreiber, Craig / Garton, Andrew L A / Jung, Brandon / Goldberg, Jacob L / Kocharian, Gary / Carnevale, Joseph A / Boddu, Srikanth R

    World neurosurgery

    2024  Volume 184, Page(s) 372–386

    Abstract: Although numerous case series and meta-analyses have shown the efficacy of venous sinus stenting (VSS) in the treatment of idiopathic intracranial hypertension and idiopathic intracranial hypertension-associated pulsatile tinnitus, there remain numerous ... ...

    Abstract Although numerous case series and meta-analyses have shown the efficacy of venous sinus stenting (VSS) in the treatment of idiopathic intracranial hypertension and idiopathic intracranial hypertension-associated pulsatile tinnitus, there remain numerous challenges to be resolved. There is no widespread agreement on candidacy; pressure gradient and failed medical treatment are common indications, but not all clinicians require medical refractoriness as a criterion. Venous manometry, venography, and cerebral angiography are essential tools for patient assessment, but again disagreements exist regarding the best, or most appropriate, diagnostic imaging choice. Challenges with the VSS technique also exist, such as stent choice and deployment. There are considerations regarding postprocedural balloon angioplasty and pharmacologic treatment, but there is insufficient evidence to formalize postoperative decision making. Although complications of VSS are relatively rare, they include in-stent stenosis, hemorrhage, and subdural hematoma, and the learning curve for VSS presents specific challenges in navigating venous anatomy, emphasizing the need for wider availability of high-quality training. Recurrence of symptoms, particularly stent-adjacent stenosis, poses challenges, and although restenting and cerebrospinal fluid-diverting procedures are options, there is a need for clearer criteria for retreatment strategies. Despite these challenges, when comparing VSS with traditional cerebrospinal fluid-diverting procedures, VSS emerges as a favorable option, with strong clinical outcomes, lower complication rates, and cost-effectiveness. Further research is necessary to refine techniques and indications and address specific aspects of VSS to overcome these challenges.
    MeSH term(s) Humans ; Pseudotumor Cerebri/complications ; Pseudotumor Cerebri/diagnostic imaging ; Pseudotumor Cerebri/surgery ; Tinnitus/etiology ; Tinnitus/surgery ; Constriction, Pathologic/diagnostic imaging ; Constriction, Pathologic/surgery ; Constriction, Pathologic/complications ; Cranial Sinuses/diagnostic imaging ; Cranial Sinuses/surgery ; Stents/adverse effects ; Intracranial Hypertension/surgery ; Intracranial Hypertension/complications ; Treatment Outcome ; Retrospective Studies
    Language English
    Publishing date 2024-04-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2023.12.164
    Database MEDical Literature Analysis and Retrieval System OnLINE

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