Neurointervention · IR Playbook

Venous Sinus Stenting for Idiopathic Intracranial Hypertension (VSS)

Venous sinus stenting treats a physiologically significant dural venous outflow stenosis in carefully selected patients with confirmed idiopathic intracranial hypertension who remain symptomatic or visually threatened despite appropriate therapy. By scaffolding the usually stenotic transverse–sigmoid segment, the stent reduces the trans-stenotic gradient, lowers upstream venous pressure and improves cerebrospinal-fluid absorption; current evidence is encouraging but remains dominated by observational studies and prospective single-arm trials rather than randomized comparisons. A 2024 meta-analysis of 1066 patients reported improvement in headache, papilledema, visual disturbance and tinnitus in 79%, 89%, 88% and 95%, respectively, while major complications such as venous perforation, intracranial hemorrhage and stent thrombosis are uncommon but potentially catastrophic.

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