Horev Anat, Lorber Dana, Vardi-Dvash Noa, Zlotnik Yair, Biederko Ron, Ifergane Gal, Shelef Ilan, Zvenigorodsky Vladislav, Horev Amir
Neurology Department, Soroka University Medical Center, Beersheba, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.
Front Neurol. 2021 Oct 15;12:711870. doi: 10.3389/fneur.2021.711870. eCollection 2021.
A pressure gradient of over 8 mm Hg across the stenosis (usually located in the transverse-sigmoid junction) is one of the criteria for cerebral venous stenting in idiopathic intracranial hypertension (IIH) patients. The possible inaccuracy of the traditional microcatheter-based pressure measurements has been discussed in previous studies. In the cardiology field, a dual-sensor pressure wire is routinely used for the evaluation of stenotic lesions. Using a pressure wire for cerebral vasculature was previously discussed in a small case series and case reports. In this study, we compared venous pressure measurements obtained using both a microcatheter and a pressure wire in patients who were candidates for stenting. A retrospective study was conducted, comparing the two methods of pressure measurements in 26 patients with venous stenosis. Altogether, 120 measurements were performed using both methods. Demographic characteristics, medical history, procedural details, medications, indications for the procedure, and complications were collected from the patient charts. Based on an 8-mm Hg pressure gradient cutoff indication, 19 patients were found eligible to go through unilateral venous stenting based on catheter measurements alone. The wire results corroborated the catheter results in detecting all cases indicated for a stent. This finding implies a sensitivity equal to 100% for the wire measurements. There were no wire-related complications, demonstrating its safety. We conclude that the pressure wire is as safe as the microcatheter and can identify cases requiring intervention. A larger-scale study is needed to assess the measurement accuracy of the pressure wire in brain vasculature.
横跨狭窄部位（通常位于横窦-乙状窦交界处）的压力梯度超过8毫米汞柱是特发性颅内高压（IIH）患者进行脑静脉支架置入术的标准之一。先前的研究已经讨论过基于传统微导管的压力测量可能存在的不准确之处。在心脏病学领域，双传感器压力导丝通常用于评估狭窄病变。此前在一个小病例系列和病例报告中讨论过将压力导丝用于脑血管系统。在本研究中，我们比较了在有支架置入术指征的患者中使用微导管和压力导丝获得的静脉压力测量结果。我们进行了一项回顾性研究，比较了26例静脉狭窄患者的两种压力测量方法。总共使用两种方法进行了120次测量。从患者病历中收集了人口统计学特征、病史、手术细节、用药情况、手术指征和并发症。基于8毫米汞柱的压力梯度截断指征，发现仅根据导管测量结果，有19例患者符合进行单侧静脉支架置入术的条件。导丝测量结果在检测所有有支架置入指征的病例中与导管测量结果一致。这一发现意味着导丝测量的灵敏度为100%。没有与导丝相关的并发症，证明了其安全性。我们得出结论，压力导丝与微导管一样安全，并且能够识别需要干预的病例。需要进行更大规模的研究来评估压力导丝在脑血管系统中的测量准确性。
