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Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension
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Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension
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Journal Article
Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension
2025
Overview
The value of intravascular ultrasound (IVUS) in the diagnosis and treatment of the venous system is not well established. Introducing a novel approach to utilizing IVUS to evaluate cerebral venous sinus (CVS) stenosis and select stent. Idiopathic intracranial hypertension (IIH) patients with CVS stenosis who underwent IVUS-guided stenting were included in the data analysis from January 2014 to February 2022. The degree of maximum stenosis was determined based on the cross-sectional area (CSA) measured by IVUS, and a stent selection method was applied in the study. Follow-up evaluations were conducted at 6 months to 1 year after endovascular treatment to assess symptom improvement. Additionally, repeated digital subtraction angiography (DSA) or Magnetic resonance venography (MRV) / CT venography（CTV） was performed to evaluate the stent patency at 6 months to 1 year post-procedure. The study included 61 patients. IVUS indicated a lower degree of stenosis compared to conventional DSA measurements when evaluating the degree of stenotic segments preprocedure (74.84 ± 10.12% vs. 78.48 ± 8.72%,
p
= 0.035). Post-procedural CSA of the most severe stenotic segments showed significant improvement (36.44 ± 8.07 mm
2
vs. 7.42 ± 3.28 mm
2
,
p
< 0.001). The stent achieved complete expansion (mean stent expansion index, 0.93 ± 0.20) with no significant change in the structure of the reference segment. The trans-stenotic mean pressure gradients (MPGs) across 61 patients significantly decreased from 11.00 ± 6.23 mmHg to 2.09 ± 2.34 mmHg. 47 out of 61 patients received imaging follow-up; among them, 44 (93.6%) demonstrated stent patency in the follow-up imaging. IVUS has great potential to evaluate the degree and extent of CVS stenosis, assist stent selection, and optimize stent position during the interventional procedure in conjunction with DSA.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ Adult
/ Angiography, Digital Subtraction
/ Constriction, Pathologic - diagnostic imaging
/ Constriction, Pathologic - surgery
/ Cranial Sinuses - diagnostic imaging
/ Digital Subtraction angiography
/ Endovascular Procedures - methods
/ Female
/ Humanities and Social Sciences
/ Humans
/ Implants
/ Male
/ Pseudotumor Cerebri - complications
/ Pseudotumor Cerebri - diagnostic imaging
/ Science
/ Stenosis
/ Stents
