From the Guidelines
Transvenous stenting in Idiopathic Intracranial Hypertension (IIH) has a complication rate that includes short-lived ipsilateral headache, stent-adjacent stenosis, vessel perforation, stent migration, and thrombosis.
Common Complications
- Short-lived ipsilateral headache is a common complication, occurring in many patients 1
- Stent-adjacent stenosis requiring retreatment occurs in approximately a third of patients 1
Rare but Serious Complications
- Vessel perforation leading to acute subdural haematoma is a rare but serious complication 1
- Stent migration and thrombosis are also rare complications 1
Management Considerations
- Long-term antithrombotic therapy is required for longer than 6 months following neurovascular stenting treatment to prevent thrombotic complications 1 It is essential to note that the role of neurovascular stenting in IIH is not yet established, and the decision to proceed with this treatment should be made on a case-by-case basis, weighing the potential benefits against the risks of complications 1.
From the Research
Complication Rates of Transvenous Stenting in IIH
The complication rates of transvenous stenting in Idiopathic Intracranial Hypertension (IIH) have been reported in several studies:
- A study published in 2022 2 reported six major acute and chronic complications after venous sinus stenting (VSS) for IIH, including acute subdural hematoma, stent thrombosis, cerebellar hemorrhage, venous microcatheter perforation, and subarachnoid hemorrhage.
- A meta-analysis published in 2024 3 found that the complication rate after VSS was 5.35%, including subdural hemorrhage, urinary tract infection, stent thrombus formation, and others.
- A study published in 2018 4 reported a complication rate of 4.9% after dural venous sinus stent (DVSS) insertion, with at least 20% of patients developing restenosis following DVSS.
- A review of the literature published in 2013 5 found a total of nine complications (6%) in 143 patients with IIH treated with venous sinus stenting.
- A study published in 2014 6 identified risk factors for failed transverse sinus stenting in pseudotumor cerebri patients, including highly elevated opening pressure pre-stenting and persistent papilledema post-stenting.
Types of Complications
The types of complications reported in these studies include:
- Subdural hematoma
- Stent thrombosis
- Cerebellar hemorrhage
- Venous microcatheter perforation
- Subarachnoid hemorrhage
- Urinary tract infection
- Restenosis
- Stent failure
Frequency of Complications
The frequency of complications reported in these studies varies: