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影响特发性颅内高压伴静脉窦狭窄支架置入术良好临床结局的因素

Factors Influencing Favourable Clinical Outcomes in Idiopathic Intracranial Hypertension with Venous Sinus Stenosis Stenting.

作者信息

He Jie, Yang Hongchao, Tong Xu, Wang Yilong, Miao Zhongrong, Mo Dapeng

机构信息

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No. 119, the South Fourth Ring West Road, 100070, Fengtai district, Beijing, China.

Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Clin Neuroradiol. 2024 Dec 10. doi: 10.1007/s00062-024-01477-1.

DOI:10.1007/s00062-024-01477-1
PMID:39656278
Abstract

PURPOSE

This study aimed to investigate the factors influencing favourable clinical outcomes in idiopathic intracranial hypertension (IIH) patients with venous sinus stenosis (VSS) who received stenting treatment.

METHODS

In this prospective cohort study, we analyzed a total of 172 IIH patients with VSS treated with venous sinus stenting. Clinical outcomes were categorized as either "complete resolved" or "improved". We employed multivariable logistic regression modeling to identify independent factors associated with the clinical outcomes. The predictive accuracy of the model was assessed using receiver operating characteristic (ROC) analysis.

RESULTS

Out of the total cohort, 126 patients exhibited asymptomatic clinical outcomes, while 46 patients showed improved clinical outcomes. Patients with asymptomatic clinical outcomes demonstrated notably lower preoperative BMI (26.8 kg/m versus 28.7 kg/m, P = 0.013). In multivariate analysis, preoperative BMI (odds ratio [OR] = 1.108, 95% confidence interval [CI] = 1.009-1.216) was an independent factor of complete resolution of the symptoms. In the receiver operating characteristic (ROC) analysis, the identified cut-off BMI for the highest sensitivity (0.5) and specificity (0.754) was determined to be 29.3 kg/m.

CONCLUSION

Lower BMI may be associated with the complete resolution of symptoms in IIH patients with VSS who received venous sinus stenting treatment.

摘要

目的

本研究旨在探讨影响接受支架治疗的伴有静脉窦狭窄(VSS)的特发性颅内高压(IIH)患者获得良好临床结局的因素。

方法

在这项前瞻性队列研究中,我们分析了总共172例接受静脉窦支架置入治疗的伴有VSS的IIH患者。临床结局分为“完全缓解”或“改善”。我们采用多变量逻辑回归模型来确定与临床结局相关的独立因素。使用受试者工作特征(ROC)分析评估模型的预测准确性。

结果

在整个队列中,126例患者表现出无症状的临床结局,而46例患者的临床结局有所改善。无症状临床结局的患者术前BMI显著较低(26.8kg/m² 对28.7kg/m²,P = 0.013)。在多变量分析中,术前BMI(比值比[OR]=1.108,95%置信区间[CI]=1.009 - 1.216)是症状完全缓解的独立因素。在受试者工作特征(ROC)分析中,确定的具有最高灵敏度(0.5)和特异性(0.754)的BMI临界值为29.3kg/m²。

结论

较低的BMI可能与接受静脉窦支架治疗的伴有VSS的IIH患者症状的完全缓解有关。

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Venous sinus stenting for idiopathic intracranial hypertension: a systematic review and meta-analysis.静脉窦支架置入术治疗特发性颅内高压:系统评价和荟萃分析。
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Effect of Body Mass Index on Venous Sinus Pressures in Idiopathic Intracranial Hypertension Patients Before and After Endovascular Stenting.体重指数对特发性颅内高压患者血管内支架置入前后静脉窦压力的影响。
Neurosurgery. 2018 Apr 1;82(4):555-561. doi: 10.1093/neuros/nyx186.