{
  "abstract": "Introduction Chronically elevated CSF pressure may cause thinning and weakening of the dural walls over venous sinuses, increasing their compliance and vulnerability to compression. This structural change is linked to bony and dural thinning at the skull base associated with spontaneous CSF leaks and IIH. Restenosis after venous sinus stenting (VSS) often occurs adjacent to the stent in weakened sinus segments, which may lead to persistent symptoms and elevated opening pressures. A high prevalence of connective tissue disorders, such as Ehlers-Danlos Syndrome, suggests a structural predisposition in IIH patients. This mechanical perspective of IIH supports VSS as a means to reinforce the collapsible venous wall.Objective The study aimed to establish a pipeline for acquiring high-resolution cross-sectional imaging of dural venous walls—specifically the transverse sinus and transverse-sigmoid junction—to measure dural thickness along the sinus course.Methods Scans were acquired using the ARTIS icono biplane system (VE30B0 software) with a 14-second DynaCT Head Micro acquisition. A 24 mL volume of 20% diluted contrast was injected via the sagittal sinus at 4 mL/s, with a 2-second X-ray delay. Raw DICOM files were exported and manually segmented in 3D Slicer. Venous wall thickness maps were generated using custom MATLAB scripts and visualized with Paraview.Results Figures A and B display the segmented sequences, while figures C and D illustrate the 3D reconstruction and corresponding dural thickness map, with the apex denoting the transverse-sigmoid junction.Conclusions This pipeline enables intra-procedural dural wall mapping without requiring additional intervention. It can also be applied to patients undergoing diagnostic angiography, where a delayed acquisition facilitates dural wall reconstruction—offering valuable control data. Furthermore, cross-sectional visualization of the dural sinus provides critical context for appropriately sizing venous sinus stents, addressing long-standing challenges associated with traditional 2D DSA-based assessments.Disclosures V. Jaikumar: None. J. Lim: None. H. Khan: None. S. Veeturi: None. V. Tutino: None.Abstract P-021 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, University at Buffalo, Buffalo, NY"
      ],
      "name": "V Jaikumar"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University at Buffalo Neurosurgery, Buffalo General Medical Center, NY"
      ],
      "name": "J Lim"
    },
    {
      "affiliations": [
        "Neurosurgery, University at Buffalo, Buffalo, NY"
      ],
      "name": "H Khan"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Texas at Houston, Houston, TX"
      ],
      "name": "C Liu"
    },
    {
      "affiliations": [
        "Canon Stroke and Vascular Research Center, Buffalo, NY"
      ],
      "name": "S Veeturi"
    },
    {
      "affiliations": [
        "Canon Stroke and Vascular Research Center, Buffalo, NY"
      ],
      "name": "V Tutino"
    },
    {
      "affiliations": [
        "University of Buffalo, Buffalo, NY"
      ],
      "name": "A Siddiqui"
    }
  ],
  "title": "P-021 Evaluating the role of dural wall thinning and sinus compliance in the pathophysiology of idiopathic intracranial hypertension: a proof of concept study",
  "uid": "42899f92-6ff8-5183-90f2-bcdc1cbf6e1e"
}