BACKGROUND AND PURPOSE The aim of this study was to assess the safety and effectiveness of lateral sinus stenosis (LSS) stenting in patients with idiopathic intracranial hypertension (IIH) who are refractory to medical treatment, particularly focusing on visual outcomes including papilledema. MATERIAL AND METHODS Retrospective study of consecutive patients with IIH refractory to medical treatment who underwent LSS stenting. Clinical features, visual fields and optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thicknesses were assessed before stenting, at 1 month poststenting and at last follow-up. Complications were also recorded. RESULTS A total of 16 women were included, with a mean age of 39 ± 11 years. All patients had papilledema while 15/16 (94%) had headaches. Mean visual acuity was 0.036 logMAR, range (+0.4 to +0.0 logMAR). The mean RNFL thickness prior to stenting was 121.7 µm (±34.7 µm) and mean GCL thickness was 80.2 µm (±8.9 µm). Mean follow-up was 19.7 months (±11.8 months). After stenting, acetazolamide was discontinued in 15/16 (94%) patients. Papilledema improved in 14/16 (88%) of patients. The mean RNFL thickness was significantly decreased 1 month after stenting (96.3 ± 15.6 µm; p < 0.001) and at last visit (93.4 ± 15.3 µm; p < 0.001). The GCL thickness after LSS stenting was moderately decreased at the last visit examination: 80.2 ± 8.9 µm vs. 78.0 ± 10.7 µm; (p < 0.01). No stent-related complication occurred, while there was one case of restenosis. CONCLUSION Improvement of papilledema appears to occur relatively rapidly after the LSS stenting. The results further support the role of LSS stenting in the treatment of IIH, especially with respect to visual symptoms.

中文翻译：

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特发性颅内高压静脉窦支架置入术后长期动态视乳头水肿的改善。

背景和目的 本研究的目的是评估对药物治疗无效的特发性颅内高压 (IIH) 患者进行侧窦狭窄 (LSS) 支架置入术的安全性和有效性，特别关注包括视乳头水肿在内的视力结果。材料和方法 对接受 LSS 支架置入的药物治疗难治性 IIH 连续患者的回顾性研究。在支架植入前、支架植入后 1 个月和最后一次随访时评估临床特征、视野和光学相干断层扫描 (OCT) 视网膜神经纤维层 (RNFL) 和神经节细胞层 (GCL) 厚度。还记录了并发症。结果 共纳入 16 名女性，平均年龄为 39 ± 11 岁。所有患者都有视乳头水肿，而 15/16 (94%) 有头痛。平均视力为 0。036 logMAR，范围（+0.4 到 +0.0 logMAR）。支架植入前的平均 RNFL 厚度为 121.7 µm (±34.7 µm)，平均 GCL 厚度为 80.2 µm (±8.9 µm)。平均随访时间为 19.7 个月（±11.8 个月）。支架植入后，15/16 (94%) 患者停用乙酰唑胺。14/16 (88%) 的患者视乳头水肿有所改善。支架植入后 1 个月（96.3 ± 15.6 µm；p < 0.001）和最后一次访问（93.4 ± 15.3 µm；p < 0.001）后，平均 RNFL 厚度显着降低。LSS 支架置入后 GCL 厚度在最后一次访视检查时适度减少：80.2 ± 8.9 µm 与 78.0 ± 10.7 µm；(p < 0.01)。未发生支架相关并发症，发生再狭窄1例。结论 LSS 支架置入术后视乳头水肿的改善似乎相对较快。