Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
Wake Forest School of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
J Neurointerv Surg. 2022 Jan;14(1). doi: 10.1136/neurintsurg-2021-017361. Epub 2021 Apr 28.
Venous sinus stenting (VSS) is a safe, effective, and increasingly popular treatment option for selected patients with idiopathic intracranial hypertension (IIH). Serious complications associated with VSS are rarely reported.
Serious complications after VSS were identified retrospectively from multicenter databases. The cases are presented and management strategies are discussed.
Six major acute and chronic complications after VSS were selected from a total of 811 VSS procedures and 1466 venograms for IIH. These included an acute subdural hematoma from venous extravasation, cases of both intraprocedural and delayed stent thrombosis, an ultimately fatal cerebellar hemorrhage resulting in acute obstructive hydrocephalus, venous microcatheter perforation during venography and manometry, and a patient who developed subarachnoid hemorrhage and subdural hematoma after cerebellar cortical vein perforation. The six cases are reviewed and learning points regarding complication avoidance and management are presented.
We report on six rare, major complications after VSS for IIH. Familiarity with these potential complications and appropriate timely management may allow for good clinical outcomes.
静脉窦支架置入术（VSS）是治疗特发性颅内高压（IIH）的一种安全、有效且日益流行的治疗选择。与 VSS 相关的严重并发症很少见。
从多个中心数据库中回顾性地确定 VSS 后的严重并发症。介绍了这些病例，并讨论了治疗策略。
从总共 811 例 IIH 的 VSS 手术和 1466 例静脉造影中，选择了 VSS 后 6 种主要的急性和慢性并发症。这些并发症包括静脉外渗引起的急性硬膜下血肿、术中及延迟支架血栓形成、最终导致急性梗阻性脑积水的致命性小脑出血、静脉微导管在静脉造影和测压过程中的穿孔，以及 1 例小脑皮质静脉穿孔后发生蛛网膜下腔出血和硬膜下血肿的患者。对这 6 个病例进行了回顾，并提出了关于避免和处理并发症的要点。
我们报告了 6 例 IIH 患者 VSS 后罕见的严重并发症。熟悉这些潜在的并发症并进行适当的及时处理，可能会获得良好的临床效果。
