{
  "abstract": "Introduction Venous sinus stenting (VSS) is an emerging treatment for idiopathic intracranial hypertension (IIH) but typically relies on contrast-based venography for lesion localization and procedural guidance. Image fusion using pre-procedural CT or MR venography may enable accurate targeting while minimizing or eliminating contrast use, as well as other indirect advantages. We report our initial experience with fusion-guided VSS and compare procedural and early clinical outcomes with conventional techniques.Materials and Methods All patients underwent standardized pre-procedural assessment, including neuro-ophthalmologic evaluation and high-quality CT or MR venography demonstrating an focal venous sinus stenosis. A venous sinus pressure gradient was confirmed with invasive venous manometry. Fusion-guided procedures utilized CT venography overlaid for live fluoroscopy for navigation and stent deployment. Procedural metrics and early clinical outcomes were compared with a cohort of conventional VSS procedures.Results Seventeen consecutive procedures were analyzed, including 4 fusion-guided and 13 conventional cases. Fusion-guided procedures demonstrated shorter procedure time (61 [56-66] vs 155 [120-230] min), fluoroscopy time (14 [6-16] vs 33 [25-51] min), lower radiation dose (157 [84-296] vs 916 [398-1219]), and were less frequently performed under general anesthesia compared with conventional cases (25% vs 54%). Contrast use was nearly eliminated in the fusion group, with only one procedure requiring minimal contrast (5 mL) related to arterial access preparation rather than venous stenting guidance. Technical success was 100% in both groups, with no procedural complications. Post-stenting pressure gradients were comparable between groups.Conclusion CT venography fusion-guided VSS is feasible, safe, and associated with substantial reductions in contrast use, radiation exposure, and procedural time. This approach enables effectively zero-contrast venous sinus stenting while maintaining procedural efficacy and represents a promising advancement in the treatment of IIH.Disclosures G. Mantovani: None. A. Mascarenhas: None. M. Maree: None. S. Pandey: None.Abstract E-044 Table 1Procedural characteristics and early outcomes of venous sinus stenting using CT venography fusion versus conventional guidanceAbstract E-044 Figure 1CT Venography fusion with live fluoroscopic roadmap demonstrating proximal right transverse sinus stenosis",
  "authors": [
    {
      "affiliations": [
        "Western University, London, ON, Canada"
      ],
      "name": "G Mantovani"
    },
    {
      "affiliations": [
        "Western University, London, ON, Canada"
      ],
      "name": "A Mascarenhas"
    },
    {
      "affiliations": [
        "Western University, London, ON, Canada"
      ],
      "name": "M Maree"
    },
    {
      "affiliations": [
        "Western University, London, ON, Canada"
      ],
      "name": "S Pandey"
    }
  ],
  "title": "E-044 Zero-contrast venous sinus stenting for idiopathic intracranial hypertension using image fusion: initial experience",
  "uid": "24395ee4-a7a0-5932-9c41-294d34516baa"
}