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Related Experiment Video

Updated: Dec 10, 2025

Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis
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Published on: February 24, 2023

873

Contralateral approach to transverse-sigmoid sinus stenting.

Weston Gordon1, Michael Abraham1,2

  • 1Department of Neurology, The University of Kansas Health System, Kansas City, KS, USA.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|September 1, 2020
PubMed
Summary

Contralateral endovascular dural venous sinus stenting (DVSS) offers a new approach for idiopathic intracranial hypertension (IIH) when standard methods fail. This technique successfully treated four patients with transverse-sinus stenosis, improving their symptoms.

Keywords:
Idiopathic intracranial hypertensiondural venous sinus stentingendovascular procedure

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Area of Science:

  • Neurosurgery
  • Interventional Radiology
  • Vascular Neurology

Background:

  • Idiopathic intracranial hypertension (IIH) is often treated with endovascular dural venous sinus stenting (DVSS).
  • Transverse-sinus stenosis with elevated mean pressure gradient (MPG) is a common cause of IIH.
  • The standard antegrade approach for DVSS may be technically challenging due to stenosis and anatomy.

Purpose of the Study:

  • To describe the novel contralateral DVSS approach for treating IIH.
  • To report the feasibility and outcomes of this alternative DVSS technique.

Main Methods:

  • Retrospective review of four female patients treated with contralateral transverse-sigmoid sinus stenting for IIH between 2019 and 2020.
  • Data collected included presenting symptoms, devices used, prior treatments, and follow-up outcomes.
  • All procedures were performed under general anesthesia.

Main Results:

  • Four female patients with severe transverse-sigmoid sinus stenosis (67-78%) and elevated MPGs (9-19 mmHg) were treated.
  • Post-stenting MPGs significantly decreased to 0-1 mmHg.
  • Three patients experienced complete symptom resolution, and one had partial resolution with no complications.

Conclusions:

  • Contralateral DVSS is a safe and effective alternative for treating IIH patients with transverse-sinus stenosis.
  • This approach expands treatment options when the antegrade route is not feasible.
  • Successful stenting from the contralateral sinus can significantly improve IIH symptoms.