Characteristics and Outcomes of the Idiopathic Intracranial Hypertension Treatment in Intrinsic and Extrinsic Stenosis: A Single-Center Experience in China.
Characteristics and Outcomes of the Idiopathic Intracranial Hypertension Treatment in Intrinsic and Extrinsic Stenosis: A Single-Center Experience in China.
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DOI：
10.1007/s40120-021-00281-0
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发表时间：
2021-12
影响因子：
3.7
通讯作者：
Mo D
中科院分区：
文献类型：
--
作者：
Raynald;Huo X;Yang H;Wang Z;Tong X;Li X;Liu L;Wang S;Miao Z;Mo D
本研究旨在探讨特发性颅内高压（IIH）和静脉窦狭窄（VSS）患者的诱发因素，并评价不同狭窄类型对治疗结果的影响。我们招募了出现内在或外在VSS的IIH患者。我们观察临床和实验室结果，然后比较不同狭窄类型的支架置入和药物治疗的结果。145例IIH合并VSS患者中，内生性59例，外源性86例。内禀组患者年龄较大（42岁vs. 34岁，P < 0.001），且术前梯度压较高（15 mmHg vs. 12 mmHg, P < 0.001）。其他诱发因素组间差异无统计学意义（P < 0.05）。支架植入术与头痛和视力受损的完全缓解显著相关，无论是内在型狭窄（调整后OR 0.017, 95% CI 0.001 - 0.35, P = 0.011；调整后OR 0.056, 95% CI 0.004-0.697, P = 0.025）还是外在型狭窄（调整后OR 0.072, 95% CI 0.015-0.343, P = 0.001；调整后OR 0.241, 95% CI 0.062-0.931, P = 0.039）。同时，与药物治疗相比，支架植入与外源性狭窄的乳头水肿改善显著相关（校正OR 0.017, 95% CI 0.002-0.135, P < 0.001）。如其他系列文章所述，在我们的患者群体中，无论内源性或外源性狭窄类型如何，支架植入术都可以为IIH患者提供实质性的临床改善。临床试验注册号ChiCTR-ONN-17010421。在线版本包含补充材料，可在10.1007/s40120-021-00281-0获得。
This study aimed to explore the precipitating factors and evaluate the impact of different stenosis types on treatment outcomes in patients with idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). We recruited patients with IIH who presented with VSS, either intrinsic or extrinsic. We observed the clinical and laboratory findings, and we then compared the outcomes of stenting and medical treatment in different stenosis types. Among 145 patients with IIH and VSS, 59 were of the intrinsic type and 86 were of the extrinsic type. Patients in the intrinsic group were older (42 vs. 34 years old, P < 0.001) and presented with higher pre-op gradient pressure (15 mmHg vs. 12 mmHg, P < 0.001). There was no significant difference between groups regarding other precipitating factors (P > 0.05). Stenting was significantly associated with complete resolution of the headache and impaired vision both in intrinsic (adjusted OR 0.017, 95% CI 0.001–0.35, P = 0.011; adjusted OR 0.056, 95% CI 0.004–0.697, P = 0.025, respectively) and extrinsic types of stenosis (adjusted OR 0.072, 95% CI 0.015–0.343, P = 0.001; adjusted OR 0.241, 95% CI 0.062–0.931, P = 0.039, respectively). Meanwhile, stenting was significantly associated with improvement of the papilledema in extrinsic-type stenosis compared with medical treatment (adjusted OR 0.017, 95% CI 0.002–0.135, P < 0.001). Stenting may provide substantial clinical improvement in patients with IIH regardless of intrinsic or extrinsic stenosis type in our patient population, as noted in other series. Clinical trial registration number ChiCTR-ONN-17010421. The online version contains supplementary material available at 10.1007/s40120-021-00281-0.
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影响因子：
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作者：
Farb, RI;Vanek, I;terBrugge, KG
通讯作者：
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影响因子：
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