{
  "abstract": "Introduction Venous sinus stenting (VSS) is increasingly performed in patients with idiopathic intracranial hypertension (IIH) who remain symptomatic despite medical therapy. A trans-stenotic venous pressure gradient is commonly used to guide intervention, with ≥8 mmHg frequently cited as the threshold for treatment. Although widely adopted, the derivation and evidentiary basis of this cutoff have not been systematically examined.Purpose To evaluate the origin, patterns of adoption, and supporting evidence behind trans-stenotic pressure gradient thresholds used to indicate VSS in IIH.Methods A bibliometric analysis was conducted in accordance with PRIBA 2023 recommendations. A Scopus search was performed on December 24, 2025, using predefined terms related to IIH and venous sinus stenting. Studies were included if they explicitly reported a pressure gradient threshold used to guide stenting. Case reports, conference abstracts, and secondary research were excluded. Study selection and data extraction were independently performed by two reviewers. Extracted variables included threshold value, type of cutoff, reported origin (primary vs secondary), geographic distribution, anesthesia status, manometry technique, pull-back methodology, and zero-reference location. Co-citation mapping was performed using VOSviewer.Results From 470 records, 62 studies met inclusion criteria. The most frequently reported threshold was ≥8 mmHg (37/62, 58.7%). Other cutoffs, including ≥4 mmHg, ≥7 mmHg, >8 mmHg, and ≥10 mmHg, were used less consistently. Rigid cutoffs were applied in 95.2% of studies.The origin of the reported threshold was not specified in 41 studies (66.1%). Among the 21 studies that addressed origin, three represented primary derivations. In these cases, the selected cutoff was introduced without prospective physiologic validation or outcome-based modeling. Eighteen studies reflected secondary adoption from prior publications. Co-citation analysis demonstrated clustering around a limited number of early reports, suggesting concentrated citation patterns rather than progressive empirical validation.Geographic variation was observed; however, ≥8 mmHg predominated in the United States, China, and the United Kingdom. Measurement techniques were relatively uniform, with microcatheter-based manometry used in 96.3% of studies and pull-back methodology applied universally. Reporting of zero-reference location was inconsistent.Conclusions The ≥8 mmHg threshold for VSS appears to have emerged from early arbitrary cutoff selection and subsequently disseminated through secondary citation. Formal physiologic validation or prospective outcome correlation is not identified in the available literature. These findings suggest the need for prospective studies linking trans-stenotic gradients to clinical response to better define evidence-based selection criteria.Disclosures J. Alzate Ramirez: None. L. Fabrini Paleare: None. B. Marçola Ishizuka: None. C. Ferreira: None. D. Langer: None. Y. Serulle: None. R. Mattay: None.",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, Lenox Hill Hospital, New York, NY"
      ],
      "name": "J Alzate Ramirez"
    },
    {
      "affiliations": [
        "Neurosurgery, Lenox Hill Hospital, New York, NY"
      ],
      "name": "L Fabrini Paleare"
    },
    {
      "affiliations": [
        "Neurosurgery, Lenox Hill Hospital, New York, NY"
      ],
      "name": "B Marçola Ishizuka"
    },
    {
      "affiliations": [
        "Neurosurgery, Lenox Hill Hospital, New York, NY"
      ],
      "name": "C Ferreira"
    },
    {
      "affiliations": [
        "Neurosurgery, Lenox Hill Hospital, New York, NY"
      ],
      "name": "D Langer"
    },
    {
      "affiliations": [
        "Neurosurgery, Lenox Hill Hospital, New York, NY"
      ],
      "name": "Y Serulle"
    },
    {
      "affiliations": [
        "Neurosurgery, Lenox Hill Hospital, New York, NY"
      ],
      "name": "R Mattay"
    }
  ],
  "title": "E-009 Trans-stenotic pressure gradient thresholds in venous sinus stenting: a bibliometric analysis of their origin and evidentiary basis",
  "uid": "09177d2f-ee7a-525f-b2d6-c22cd284a82c"
}