{
  "abstract": "Background Venous sinus stenting (VSS) is an established treatment option for patients with idiopathic intracranial hypertension (IIH) and venous outflow obstruction. However, a subset of patients experience persistent or recurrent symptoms following treatment. This study evaluates outcomes of VSS, predictors of unsatisfactory response, and the role of repeat interventions.Methods A retrospective single-center study was conducted including all consecutive patients who underwent VSS for IIH between 2021 and 2024. Patients with venous sinus compression secondary to tumors or other non-IIH causes were excluded. Demographic, clinical, and procedural variables were analyzed. Unsatisfactory response was defined as persistent or recurrent IIH-related symptoms prompting renewed healthcare contact or intervention. Logistic regression identified predictors of treatment failure.Results A total of 112 patients (mean age 37 years, median BMI 38 kg/m 2, 94% female) were included. Headache (91%), papilledema (79%), and pulsatile tinnitus (71%) were the most common presenting symptoms. The median pressure gradient was 12 mmHg and opening pressure 32.5 cmH2O. After VSS, papilledema resolved in 81%, tinnitus in 56%, headache in 47%, and subjective visual symptoms improved in 63% of cases. An unsatisfactory response to VSS treatment occurred in 41 patients (37%). On regression analysis, prior shunt was the only independent predictor of unsatisfactory response (OR 4.71, 95% CI 1.42-18.5, p = 0.015).At a median of 244 days following unsuccessful index VSS, 29 patients (26%) underwent repeat surgical intervention, including repeat VSS (n = 17) or shunt placement (n = 14). Improvement occurred in 50% after repeat stenting and 36%after shunting.Conclusion VSS seems to be effective in treating the majority of patients with IIH, achieving substantial symptom resolution and low complication rates. Prior shunt surgery was associated with a significantly higher risk of persistent or recurrent symptoms. Repeat stenting provided additional benefit in approximately half of patients, while shunting yielded more moderate improvements.Disclosures V. El-Hajj: None. M. Gharios: None.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA"
      ],
      "name": "V El-Hajj"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA"
      ],
      "name": "M Gharios"
    },
    {
      "affiliations": [
        "Neurosurgery, Thomas Jefferson University, Philadelphia, PA"
      ],
      "name": "J Roy"
    },
    {
      "affiliations": [
        "Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA"
      ],
      "name": "B Musmar"
    },
    {
      "affiliations": [
        "Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA"
      ],
      "name": "M Gooch"
    },
    {
      "affiliations": [
        "Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA"
      ],
      "name": "S Tjoumakaris"
    },
    {
      "affiliations": [
        "Thomas Jefferson University Hospital, Philadelphia, PA"
      ],
      "name": "P Jabbour"
    }
  ],
  "title": "E-095 Predictors of unsatisfactory outcomes following venous sinus stenting for idiopathic intracranial hypertension",
  "uid": "e9ff8c83-d4a3-5b72-be26-623ca2fbeaf9"
}