{Reference Type}: Journal Article
{Title}: Venous sinus stenting under conscious sedation.
{Author}: Kalsoum E;Scarcia L;Abdalkader M;Dmytriw AA;Farhat F;Tuilier T;Geismar M;Quesnel C;Tourbah A;Abdellaoui M;Nguyen TN;Kikano R;El Ojaimi R;
{Journal}: J Neurointerv Surg
{Volume}: 0
{Issue}: 0
{Year}: 2024 Aug 9
{Factor}: 8.572
{DOI}: 10.1136/jnis-2024-022109
{Abstract}: <B>BACKGROUND: </B>Venous sinus stenting (VSS) is an increasingly performed procedure for the treatment of idiopathic intracranial hypertension (IIH) refractory to medical treatment. VSS is typically performed under general anesthesia.<BR><B>OBJECTIVE: </B>To present our experience of VSS in patients with IIH performed under conscious sedation.<BR><B>METHODS: </B>Retrospective review of a prospectively maintained database of all patients with IIH who underwent VSS in a single center between September 2019 and January 2024. The sedation protocol consisted of a remifentanil-based target-controlled infusion. Patients' clinical and radiological data, dosage of anesthesia, procedural characteristics, and outcomes were collected.<BR><B>RESULTS: </B>Twenty-six patients with IIH underwent venous manometry (VM) and VSS under awake sedation and were included in our study. Patients were predominantly women (24/26) with a median age (IQR) of 33 (13) years. The median (IQR) body mass index was 34 (10) kg/m2. There was no need for general anesthesia conversion. Technical success was achieved in all patients. Median (IQR) follow-up after stenting was 7 (2) months. All patients reported resolution of the pulsatile tinnitus; headaches regressed in 20/24 (83.3%) patients and papilledema improved in 16/20 (80%). Only one non-neurological complication (retroperitoneal hematoma) occurred, without any permanent morbidity or mortality.<BR><B>CONCLUSIONS: </B>Our study confirms that performing VM and VSS under conscious sedation is safe and feasible. Conscious sedation is a viable alternative to general anesthesia for managing IIH in these patients.