Symptom Phenotypes and Treatment Failure of Dural Venous Sinus Stenting in Idiopathic Intracranial Hypertension: A Nationwide Analysis - PubMed
8 hours ago
- #Treatment Failure
- #Dural Venous Sinus Stenting
- #Idiopathic Intracranial Hypertension
- Dural venous sinus stenting (VSS) is used for idiopathic intracranial hypertension (IIH), especially with venous sinus stenosis, but real-world treatment failure rates are unclear.
- A nationwide retrospective study of 1,497 IIH patients who underwent elective VSS found a 300-day IIH-related readmission rate of 9.6% and a repeat intervention rate of 6.5%.
- Patients presented with visual-only symptoms (18.9%), headache-only (16.0%), visual with other symptoms (10.7%), or mixed/other symptoms without visual loss (54.4%).
- Headache-only presentations had a significantly higher risk of readmission (18.5%) compared to visual-only (2.6%), with a hazard ratio of 8.35.
- Visual-plus-other and nonvisual mixed phenotypes also showed increased readmission risks (HR 4.25 and 4.50), though repeat intervention trends were not statistically significant.
- The study highlights that headache-only and mixed-symptom phenotypes are linked to worse VSS outcomes, emphasizing the need for individualized risk assessment and symptom-specific patient counseling.