PDF(Pubmed)
Abstract：
UNASSIGNED: To characterise the ophthalmic indications for, and ophthalmic efficacy of, transverse sinus stenting in adults with medically refractory idiopathic intracranial hypertension.
UNASSIGNED: A retrospective cohort study was undertaken on a single-author database of 226 successive patients with confirmed idiopathic intracranial hypertension (IIH). A total of 32 patients were identified who received a transverse sinus stent for medically refractory disease. This which was defined as visual threat and/or intolerance of maximal medical therapy. Patients with medically refractory disease proceeded to stenting, if found to have a significant transverse sinus stenosis gradient at catheter venography. Visual threat was quantified via the degree of papilledema on optical coherence tomography of the retinal nerve fibre layer, and via the visual field mean deviation. CSF opening pressure at lumbar puncture and cerebral venous sinus pressure measurements from catheter venography were correlated with the ophthalmic data, noting also intolerance of maximal medical therapy. Complications of stenting were fully assessed.
UNASSIGNED: Medically refractory IIH was found in 18% of the total cohort of IIH patients. 90% of those with medically refractory disease had a significant transverse sinus stenosis pressure gradient, and 80% proceeded to stenting. The intervention eliminated papilledema in 96% of stented patients, and allowed 81% to cease acetazolamide. The need for a further procedure was low at 6%, and the safety profile was favourable.
UNASSIGNED: Medically refractory disease in IIH is common (18%), and nearly always associated with a significant transverse sinus stenosis pressure gradient (90%). Endovascular stenting of the stenosis deserves wider uptake as a highly effective, safe, and usually definitive treatment. It safeguards vision by eliminating papilledema (96%), and allows most patients to cease acetazolamide (81%). By analogy with glaucoma, if acetazolamide is the prostaglandin of IIH and CSF diversion the emergency glaucoma filter, stenting is the minimally invasive glaucoma surgery.
UNASSIGNED: A retrospective cohort study was undertaken on a single-author database of 226 successive patients with confirmed idiopathic intracranial hypertension (IIH). A total of 32 patients were identified who received a transverse sinus stent for medically refractory disease. This which was defined as visual threat and/or intolerance of maximal medical therapy. Patients with medically refractory disease proceeded to stenting, if found to have a significant transverse sinus stenosis gradient at catheter venography. Visual threat was quantified via the degree of papilledema on optical coherence tomography of the retinal nerve fibre layer, and via the visual field mean deviation. CSF opening pressure at lumbar puncture and cerebral venous sinus pressure measurements from catheter venography were correlated with the ophthalmic data, noting also intolerance of maximal medical therapy. Complications of stenting were fully assessed.
UNASSIGNED: Medically refractory IIH was found in 18% of the total cohort of IIH patients. 90% of those with medically refractory disease had a significant transverse sinus stenosis pressure gradient, and 80% proceeded to stenting. The intervention eliminated papilledema in 96% of stented patients, and allowed 81% to cease acetazolamide. The need for a further procedure was low at 6%, and the safety profile was favourable.
UNASSIGNED: Medically refractory disease in IIH is common (18%), and nearly always associated with a significant transverse sinus stenosis pressure gradient (90%). Endovascular stenting of the stenosis deserves wider uptake as a highly effective, safe, and usually definitive treatment. It safeguards vision by eliminating papilledema (96%), and allows most patients to cease acetazolamide (81%). By analogy with glaucoma, if acetazolamide is the prostaglandin of IIH and CSF diversion the emergency glaucoma filter, stenting is the minimally invasive glaucoma surgery.
摘要：
■要表征眼科适应症，和眼科功效，成人难治性特发性颅内高压患者的横窦支架置入术。
■对226名确诊为特发性颅内高压（IIH）的连续患者的单作者数据库进行了一项回顾性队列研究。总共有32例患者接受了用于治疗难治性疾病的横窦支架。这被定义为视觉威胁和/或对最大药物治疗的不耐受。患有药物难治性疾病的患者进行了支架置入术，如果在导管静脉造影中发现有明显的横向窦狭窄梯度。通过视网膜神经纤维层光学相干断层扫描上的视神经乳头水肿程度来量化视觉威胁，并通过视野平均偏差。腰椎穿刺时的CSF开口压力和导管静脉造影的脑静脉窦压力测量值与眼科数据相关。也注意到最大的药物治疗的不耐受。充分评估了支架置入的并发症。
■在IIH患者总数的18％中发现了医学难治性IIH。90%的药物难治性疾病患者有显著的横窦狭窄压力梯度，80%进行支架置入。干预消除了96％的支架患者的乳头水肿，并允许81%的人停止乙酰唑胺。对进一步手术的需求很低，为6%，安全状况良好。
■IIH的医学难治性疾病很常见（18％），并且几乎总是与显着的横窦狭窄压力梯度（90％）相关。血管内支架置入术作为一种非常有效的方法，值得更广泛地吸收狭窄，安全,通常是明确的治疗。它通过消除乳头水肿(96%)来保护视力，并允许大多数患者停止乙酰唑胺（81％）。类比青光眼，如果乙酰唑胺是IIH和CSF分流的前列腺素紧急青光眼过滤器，支架术是青光眼微创手术。
■对226名确诊为特发性颅内高压（IIH）的连续患者的单作者数据库进行了一项回顾性队列研究。总共有32例患者接受了用于治疗难治性疾病的横窦支架。这被定义为视觉威胁和/或对最大药物治疗的不耐受。患有药物难治性疾病的患者进行了支架置入术，如果在导管静脉造影中发现有明显的横向窦狭窄梯度。通过视网膜神经纤维层光学相干断层扫描上的视神经乳头水肿程度来量化视觉威胁，并通过视野平均偏差。腰椎穿刺时的CSF开口压力和导管静脉造影的脑静脉窦压力测量值与眼科数据相关。也注意到最大的药物治疗的不耐受。充分评估了支架置入的并发症。
■在IIH患者总数的18％中发现了医学难治性IIH。90%的药物难治性疾病患者有显著的横窦狭窄压力梯度，80%进行支架置入。干预消除了96％的支架患者的乳头水肿，并允许81%的人停止乙酰唑胺。对进一步手术的需求很低，为6%，安全状况良好。
■IIH的医学难治性疾病很常见（18％），并且几乎总是与显着的横窦狭窄压力梯度（90％）相关。血管内支架置入术作为一种非常有效的方法，值得更广泛地吸收狭窄，安全,通常是明确的治疗。它通过消除乳头水肿(96%)来保护视力，并允许大多数患者停止乙酰唑胺（81％）。类比青光眼，如果乙酰唑胺是IIH和CSF分流的前列腺素紧急青光眼过滤器，支架术是青光眼微创手术。
