{
  "abstract": "Background Dynamic internal jugular vein (IJV) stenosis is increasingly recognized in patients with cerebral venous outflow disorders (CVD). Although the hemodynamic effects of dynamic jugular stenosis have been characterized, its role in disease remains undefined. This study evaluated the safety and early outcomes of IJV stenting for symptomatic rotational stenosis.Methods This retrospective, single-institution study included adult patients that underwent IJV stenting for dynamic, symptomatic IJV stenosis between 2023 and 2025. Inclusion required dynamic venography demonstrating >75% rotational IJV stenosis and ≥6 mmHg trans-stenotic pressure gradient. Demographic, procedural, and clinical data were analyzed. Symptom severity was assessed using the Cerebral Venous Disorder Symptom Severity (CVDSS) scale and the Headache Impact Test (HIT-6).Results Sixteen patients (mean age 37.1 years, 75% female) were included. All underwent successful IJV stent placement without periprocedural complications. The median trans-stenotic pressure gradient improved from 7 mmHg (range 6–18) to 1 mmHg (range 0–9) after stenting. CVDSS scores improved from 13.5 (11.0–16.0) to 8.5 (4.75–12.0) at peak improvement (p<0.001), with sustained improvement (10.5 (8.0–12.3), p<0.001) at a median follow-up of 10.1 months. Median HIT-6 scores decreased from 65.5 (64.0–67.3) to 61.0 (57.0–64.0) (p<0.001). Thirteen patients reported meaningful symptom improvement at last follow-up, and 88% were satisfied with their decision to pursue stenting.Conclusion Jugular vein stenting in refractory CVD patients with severe, symptomatic rotational IJV stenosis is technically feasible and associated with meaningful clinical improvement in patients though partial symptom recurrence is common. Optimal patient selection and procedural expertise are essential to maximize patient safety and efficacy.",
  "authors": [
    {
      "affiliations": [
        "Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA"
      ],
      "name": "Kyle M Fargen"
    },
    {
      "affiliations": [
        "Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA"
      ],
      "name": "Omar Ashraf"
    },
    {
      "affiliations": [
        "Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA"
      ],
      "name": "Allison Medina"
    },
    {
      "affiliations": [
        "Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA"
      ],
      "name": "Jackson P Midtlien"
    },
    {
      "affiliations": [
        "Neurological Surgery and Radiology, Wake Forest University, Winston-Salem, North Carolina, USA"
      ],
      "name": "Connor Margraf"
    },
    {
      "affiliations": [
        "Biostatistics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"
      ],
      "name": "Molly R Ehrig"
    },
    {
      "affiliations": [
        "Biostatistics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA"
      ],
      "name": "Carol Kittel"
    },
    {
      "affiliations": [
        "Prisma Health Southeastern Neurosurgical and Spine Institute, Greenville, South Carolina, USA"
      ],
      "name": "Jan Vargas"
    },
    {
      "affiliations": [
        "School of Medicine, Riverside Community Hospital, Riverside, California, USA",
        "Neurointerventional Radiology, Riverside University Health System Medical Center, Moreno Valley, California, USA"
      ],
      "name": "Charles Stout"
    },
    {
      "affiliations": [
        "Neurosurgery, Canon Stroke and Vascular Research Center, SUNY University at Buffalo, Buffalo, New York, USA"
      ],
      "name": "Adnan Siddiqui"
    },
    {
      "affiliations": [
        "Radiology, Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Ferdinand Hui"
    }
  ],
  "title": "Internal jugular vein stenting for symptomatic severe rotational stenosis",
  "uid": "0de654c6-567a-5575-afea-0b913604e97b"
}