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Dural venous sinus stenting in the treatment of idiopathic intracranial hypertension: A systematic review and critique of literature
Survey of Ophthalmology ( IF 5.1 ) Pub Date : 2021-05-15 , DOI: 10.1016/j.survophthal.2021.05.002
Anna Kabanovski 1 , Eli Kisilevsky 2 , Yelin Yang 2 , Edward Margolin 3
Affiliation  

Idiopathic intracranial hypertension (IIH) is increased intracranial pressure without a known cause. Dural venous sinus stenting (DVSS) is a relatively new intervention for treatment of IIH refractory to medical therapy and lifestyle modifications. In this review, we outline various hypotheses of IIH pathogenesis and describe the role of venous sinus stenosis and the technical details of DVSS. We also present a summary and critique of the available evidence describing the outcomes of DVSS in IIH and review the evidence-based guidelines for this procedure. We conclude that, although many studies have shown generally favorable outcomes of DVSS in patients with IIH, most have serious limitations, the most common one being paucity of pre- and postprocedure ophthalmological data. Thus, there is not enough available evidence to conclude whether DVSS is an effective procedure for treatment of IIH. We also present the most commonly used indications for DVSS as described in the literature and stress the importance of neuro-ophthalmological assessment before and after the procedure to monitor response and potential complications.



中文翻译:

硬脑膜静脉窦支架治疗特发性颅内高压:系统评价和文献评论

特发性颅内高压 (IIH) 是无已知原因的颅内压升高。硬脑膜静脉窦支架置入术(DVSS)是一种相对较新的干预措施,用于治疗药物治疗和生活方式改变难以治愈的 IIH。在这篇综述中,我们概述了 IIH 发病机制的各种假设,并描述了静脉窦狭窄的作用和 DVSS 的技术细节。我们还对描述 IIH 中 DVSS 结果的现有证据进行了总结和批评,并审查了该程序的循证指南。我们得出的结论是,尽管许多研究表明 DVSS 在 IIH 患者中的结果普遍良好,但大多数都有严重的局限性,最常见的是缺乏术前和术后眼科数据。因此,没有足够的可用证据来断定 DVSS 是否是治疗 IIH 的有效程序。我们还介绍了文献中描述的 DVSS 最常用的适应症,并强调了在手术前后进行神经眼科评估以监测反应和潜在并发症的重要性。

更新日期:2021-05-15
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