Guo Xin-Bin, Wei Sen, Guan Sheng
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Neurol. 2019 Jul 12;10:751. doi: 10.3389/fneur.2019.00751. eCollection 2019.
Venous sinus stenting (VSS) is a well-acknowledged treatment strategy for patients with a high venous sinus pressure gradient across the site of outflow obstruction. It is not clear whether intracranial venous pressure manometry should be performed awake or under general anesthesia (GA). The aim of this study is to compare the accuracy of venous manometry performed under GA or awake setting, and to evaluate stenting candidates to be determined under awake setting or under GA. The manometry results of 32 patients with idiopathic intracranial hypertension (IIH) were recorded under awake setting and general anesthesia before stenting. Mean venous pressures (MVPs) and trans-stenosis pressure gradients were obtained and compared between awake setting and general anesthesia status. MVPs and trans-stenosis pressure gradients of 32 patients under GA and awake pressure setting were recorded. MVPs in the superior sagittal sinus, torcula, and transverse sinus were lower in the GA group, without statistical significant difference ( > 0.05). MVPs were significantly higher in the sigmoid sinus and jugular bulb under GA group ( < 0.05). Mean trans-stenosis pressure gradient was significantly lower in the group under GA ( < 0.05). Intracranial venous pressure seems to be affected by different levels of consciousness. Our study reveals that intracranial venous pressure is lower under general anesthesia than in the awake setting, which may have a potential impact on patient selection for venous sinus stenting.
静脉窦支架置入术（VSS）是一种公认的治疗策略，适用于静脉窦压力梯度在流出道梗阻部位较高的患者。目前尚不清楚颅内静脉压测量应在清醒状态下还是全身麻醉（GA）下进行。本研究的目的是比较在GA或清醒状态下进行静脉测压的准确性，并评估在清醒状态或GA下确定的支架置入候选者。在支架置入前，记录了32例特发性颅内高压（IIH）患者在清醒状态和全身麻醉下的测压结果。获取平均静脉压（MVPs）和跨狭窄压力梯度，并在清醒状态和全身麻醉状态之间进行比较。记录了32例患者在GA和清醒压力设置下的MVPs和跨狭窄压力梯度。GA组上矢状窦、窦汇和横窦的MVPs较低，无统计学显著差异（>0.05）。GA组乙状窦和颈静脉球的MVPs显著较高（<0.05）。GA组的平均跨狭窄压力梯度显著较低（<0.05）。颅内静脉压似乎受不同意识水平的影响。我们的研究表明，全身麻醉下的颅内静脉压低于清醒状态，这可能对静脉窦支架置入术的患者选择有潜在影响。
