特发性颅内高压患者脑静脉窦内的压力变化
Pressure variations in cerebral venous sinuses of idiopathic intracranial hypertension patients.
作者信息
Boddu Srikanth R, Gobin Pierre, Oliveria Cristiano, Dinkin Marc, Patsalides Athos
机构信息
Division of Interventional Neuroradiology, Department of Neurological surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.
Department of Interventional Neuroradiology, New York Presbyterian Queens Hospital, Flushing, NY, USA.
出版信息
J Vasc Interv Neurol. 2018 Jun;10(1):25-30.
PURPOSE
To evaluate the alteration of pressure characteristics in the cerebral venous sinuses before and after venous sinus stenting (VSS) using mean sinus pressures (MSPs), sinus pressure gradient (SPG), and sinus pressure pulsatility (SPP) parameters among the idiopathic intracranial hypertension (IIH) patients.
MATERIALS AND METHODS
Prospective evaluation of 45 consecutive IIH patients who underwent VSS at our institution. A written informed consent approved by the Weill Cornell Institutional Review Board was signed by the study participants. All patients ( = 45) were evaluated for MSPs and SPG. In a subgroup of 12 ( = 12) consecutive patients, SPP was measured. MSP was measured using microcatheter at superior sagittal sinus (SSS), transverse sinus (TS), and sigmoid sinus (SS). SPG was measured as trans-stenotic gradient and trans-torcular gradient. SPP was recorded in the dominant TS with a six French intermediate catheter. Statistical analysis was performed using paired student -test and two sample -tests tested for both equal and unequal variances. values below 0.05 were considered significant.
RESULTS
The mean age of the study population was 30.6 ± 10 years (7-59 years) and 43 out of 45 are female patients. The mean weight and BMI of the study population were 96 ± 24.7 kg (30.8-144 kg) and 35.6 ± 8.3 kg/M (16.4-51.4 kg/M), respectively. VSS in IIH patients resulted in immediate reduction of MSP in the SSS {Δ Mean: -8.1 mm Hg [95% confidence interval (CI): -5.0-11.7 mm Hg], < 0.001} and TS [Δ Mean: -11.8 mm Hg (95% CI: -7.5 to 13.4 mm Hg), p < 0.001] and increase of MSP in SS [Δ Mean: 7.5 mm Hg (95% CI: 6-10.1 mm Hg), p < 0.001]. Significant reduction of trans-stenotic SPG reduction [Δ Mean: -15.7 mm Hg (95% CI: -13.6-17.8 mm Hg), p < 0.001] and SPP [Δ Mean: -8 mm Hg (95% CI: -2.5-13.4 mm Hg), p < 0.05] was observed following VSS.
CONCLUSION
VSS resulted in immediate alteration of the cerebral venous sinus pressure measurements in patients with IIH.
目的
利用特发性颅内高压（IIH）患者的平均窦压（MSP）、窦压梯度（SPG）和窦压搏动性（SPP）参数，评估静脉窦支架置入术（VSS）前后脑静脉窦压力特征的变化。
材料与方法
对我院连续45例行VSS的IIH患者进行前瞻性评估。研究参与者签署了经威尔康奈尔机构审查委员会批准的书面知情同意书。对所有45例患者评估MSP和SPG。在连续12例患者的亚组中测量SPP。使用微导管在上矢状窦（SSS）、横窦（TS）和乙状窦（SS）测量MSP。测量跨狭窄梯度和跨窦汇梯度作为SPG。使用6F中间导管在优势TS记录SPP。采用配对学生t检验和双样本t检验进行统计学分析，检验方差齐性和非齐性。P值小于0.05被认为具有统计学意义。
结果
研究人群的平均年龄为30.6±10岁（7 - 59岁），45例患者中有43例为女性。研究人群的平均体重和BMI分别为96±24.7kg（30.8 - 144kg）和35.6±8.3kg/m²（16.4 - 51.4kg/m²）。IIH患者行VSS后，SSS的MSP立即降低{平均变化：-8.1mmHg[95%置信区间（CI）：-5.0 - 11.7mmHg]，P<0.001}，TS的MSP也降低[平均变化：-11.8mmHg（95%CI：-7.5至13.4mmHg），P<0.001]，而SS的MSP升高[平均变化：7.5mmHg（95%CI：6 - 10.1mmHg），P<0.001]。VSS后观察到跨狭窄SPG显著降低[平均变化：-15.7mmHg（95%CI：-13.6 - 17.8mmHg），P<0.001]和SPP降低[平均变化：-8mmHg（95%CI：-2.5 - 13.4mmHg），P<0.05]。
结论
VSS导致IIH患者脑静脉窦压力测量值立即改变。
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