Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Tongliao City Hospital, Inner Mongolia Autonomous Region, China.
Curr Neurovasc Res. 2019;16(1):77-81. doi: 10.2174/1567202616666190206185133.
Cerebral Venous Sinus Stenosis (CVSS) usually results in severe Intracranial Hypertension (IH), which can be corrected by stenting immediately. However, there is a lack of evidence of the long-term good outcomes in patients with CVSS who underwent stenting.
A total of 62 patients with imaging confirmed non-thrombotic and non-external compression CVSS were enrolled into this single center real-world cohort study after undergoing stenting, and were continuously followed up for more than 12 years. The symptoms and signs of IH prior to stenting and post-stenting and the incidence of restenosis after stenting were analyzed.
The mean age of the 62 patients (range, 13 to 62) was 40 years old, and the mean body mass index was 26 (range 23 to 40). Females accounted for 67.7% (42/62). Headache was the most common symptom (79%). Transient visual obscurations occurred in 69% of the patients. 42% of the patients suffered from visual loss, 11.3% pulsatile tinnitus, and 96.8% Papilledema before stenting. The mean trans-stenotic pressure gradients were 643 mmHg prior to stenting and returned to 04 mmHg after stent placement. During the following 12~126 months (the median was 62) after stenting of the follow-up, 91.9% (57/62) of the patients obtained good outcomes. Headaches disappeared in 96% (47/49) of the patients and papilledema was attenuated in 98.3% (59/60). However, There were still 8.0 % (5/62) of the patients with poor outcomes, including optic disc atrophy in 3 patients and stent-interior thrombosis in 2 patients, which occurred 6.3 months after stenting.
Our data suggest that stenting may be a promising therapy for CVSS correcting. Patients with CVSS may get long-term benefit from stenting, especially when they are accompanied with severe IH.
脑静脉窦狭窄（CVSS）通常会导致严重的颅内高压（IH），可以通过支架置入术立即纠正。然而，对于接受支架置入术的 CVSS 患者，缺乏长期预后良好的证据。
本单中心真实世界队列研究共纳入 62 例经影像学证实的非血栓性和非外压性 CVSS 患者，所有患者均接受支架置入术治疗，并进行了超过 12 年的连续随访。分析了支架置入术前和术后 IH 的症状和体征以及支架置入术后再狭窄的发生率。
62 例患者的平均年龄（范围，1362）为 40 岁，平均体重指数（BMI）为 26（范围 2340）。女性占 67.7%（42/62）。头痛是最常见的症状（79%）。69%的患者出现一过性视力模糊。42%的患者出现视力丧失，11.3%的患者出现搏动性耳鸣，96.8%的患者出现视乳头水肿。支架置入术前跨狭窄压力梯度为 643mmHg，支架置入后恢复至 04mmHg。在支架置入后 12~126 个月（中位时间为 62 个月）的随访期间，91.9%（57/62）的患者获得了良好的结局。96%（47/49）的患者头痛消失，98.3%（59/60）的患者视乳头水肿减轻。然而，仍有 8.0%（5/62）的患者预后较差，包括 3 例视神经萎缩和 2 例支架内血栓形成，均发生在支架置入后 6.3 个月。
我们的数据表明，支架置入术可能是治疗 CVSS 的一种有前途的方法。CVSS 患者可能会从支架置入术中获得长期获益，尤其是当他们伴有严重 IH 时。
