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. 2025 Aug 13;17(9):939-942.
doi: 10.1136/jnis-2024-022109.

Venous sinus stenting under conscious sedation

Erwah Kalsoum #  1 , Luca Scarcia #  2 , Mohamad Abdalkader  3 , Adam A Dmytriw  4   5 , Firas Farhat  2 , Titien Tuilier  2 , Maxime Geismar  2 , Christophe Quesnel  6 , Ayman Tourbah  7 , Mohamed Abdellaoui  8 , Thanh N Nguyen  9 , Raghid Kikano #  10 , Rami El Ojaimi #  6
Affiliations

Venous sinus stenting under conscious sedation

Erwah Kalsoum et al. J Neurointerv Surg. .

Abstract

Background: Venous sinus stenting (VSS) is an increasingly performed procedure for the treatment of idiopathic intracranial hypertension (IIH) refractory to medical treatment. VSS is typically performed under general anesthesia.

Objective: To present our experience of VSS in patients with IIH performed under conscious sedation.

Methods: Retrospective review of a prospectively maintained database of all patients with IIH who underwent VSS in a single center between September 2019 and January 2024. The sedation protocol consisted of a remifentanil-based target-controlled infusion. Patients' clinical and radiological data, dosage of anesthesia, procedural characteristics, and outcomes were collected.

Results: Twenty-six patients with IIH underwent venous manometry (VM) and VSS under awake sedation and were included in our study. Patients were predominantly women (24/26) with a median age (IQR) of 33 (13) years. The median (IQR) body mass index was 34 (10) kg/m2. There was no need for general anesthesia conversion. Technical success was achieved in all patients. Median (IQR) follow-up after stenting was 7 (2) months. All patients reported resolution of the pulsatile tinnitus; headaches regressed in 20/24 (83.3%) patients and papilledema improved in 16/20 (80%). Only one non-neurological complication (retroperitoneal hematoma) occurred, without any permanent morbidity or mortality.

Conclusion: Our study confirms that performing VM and VSS under conscious sedation is safe and feasible. Conscious sedation is a viable alternative to general anesthesia for managing IIH in these patients.

Keywords: Angioplasty; Blood Flow; Drug; Intracranial Pressure; Vein.

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Conflict of interest statement

Competing interests: None declared.

References

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