Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
Ann Clin Transl Neurol. 2023 Aug;10(8):1305-1313. doi: 10.1002/acn3.51822. Epub 2023 Jun 5.
To compare the long-term safety and efficacy of stenting in correcting cerebral venous sinus stenosis (CVSS) and internal jugular venous stenosis (IJVS).
Patients confirmed with CVSS or IJVS by imaging were enrolled in this real-world study from 2014 through 2021. Clinical characteristics and long-term outcomes of these two diseases entities post-stenting were followed up and compared.
Three hundred and nineteen patients were enrolled in this study, with a mean age of 48.83 years and a BMI of 25.08 on average. In which, 144 patients underwent stenting, the stenotic segments were corrected and the venous blood flow was restored immediately post-stenting. At 6.15 ± 1.67 days follow-up, significant improvement was observed in headache, tinnitus, insomnia, ICP, and mean pressure gradient in both groups (all p < 0.05). At 30.53 ± 4.41 months follow-up post-stenting, the headache, tinnitus, visual loss, papilledema, and insomnia were attenuated remarkably or even completely disappeared. The Frisen papilledema grade scores declined from 2 (0-4) to 1 (0-3) in IJVS group and from 4 (1-5) to 1 (0-4) in CVSS group compared to the baseline. One hundred and twenty-seven out of the 144 patients (95.5%) maintained sufficient blood flow verified by followed up computed tomographic venography or contrast-enhanced magnetic resonance angiography. Adverse events related to stenting included three cases of intraluminal restenosis and three cases of in-stent thrombosis, no intracranial hemorrhage, venous thromboembolisms, stent-adjacent stenosis, and stent displacement occurred.
Using stents to correct IH and related neurological issues has shown to be a safe and effective approach for both IJVS and CVSS.
比较支架置入治疗脑静脉窦狭窄（CVSS）和颈内静脉狭窄（IJVS）的长期安全性和疗效。
本研究为真实世界研究，纳入 2014 年至 2021 年间通过影像学检查确诊为 CVSS 或 IJVS 的患者。对两组患者支架置入术后的临床特征和长期预后进行随访和比较。
本研究共纳入 319 例患者，平均年龄 48.83 岁，平均 BMI 为 25.08。其中 144 例行支架置入术，术后即刻狭窄段矫正，静脉血流恢复。在支架置入术后 6.15±1.67 天随访时，两组患者头痛、耳鸣、失眠、颅内压（ICP）及平均压力梯度均有显著改善（均 P<0.05）。在支架置入术后 30.53±4.41 个月随访时，头痛、耳鸣、视力下降、视乳头水肿和失眠明显减轻甚至完全消失。IJVS 组 Frisen 视乳头水肿分级从基线的 2 级（0-4 级）降至 1 级（0-3 级），CVSS 组从 4 级（1-5 级）降至 1 级（0-4 级）。144 例患者中有 127 例（95.5%）通过随访 CT 静脉造影或增强磁共振血管成像证实维持足够的血流。与支架置入相关的不良事件包括 3 例管腔再狭窄和 3 例支架内血栓形成，无颅内出血、静脉血栓栓塞、支架相邻狭窄和支架移位发生。
使用支架矫正 IH 及其相关神经问题，对于 IJVS 和 CVSS 均是一种安全有效的治疗方法。
