Stenting versus balloon angioplasty alone for idiopathic intracranial hypertension

Stenting is a common approach for treating idiopathic intracranial hypertension (IIH) and venous sinus stenosis (VSS). However, studies comparing stenting with balloon angioplasty alone are lacking. This study sought to compare the clinical efficacy of balloon angioplasty and stenting in the treatment of IIH and VSS.

In this single-center retrospective study, patients were divided into the following two groups: Group S, which comprised patients who underwent stenting with or without balloon angioplasty; and Group B, which comprised patients who underwent balloon angioplasty alone. From January 2018 to June 2023, the medical records of patients with IIH and VSS were evaluated to compare their postsurgical results and subsequent clinical outcomes.

In total, 122 participants were included in this study; 64 in Group S, and 58 in Group B. There were no differences between the two groups in terms of their initial traits. The efficacy of Group B was similar to that of Group S in terms of headache, sixth nerve palsy, and tinnitus at discharge (all P>0.05); however, the proportion of patients with resolved symptoms was significantly greater in Group S than Group B at the 3-, 6-, and 12-month follow-up (all P<0.05). The patients in Group S had a significantly lower median papilledema Frisén grade (1 vs. 2, P<0.001), a lower mean lumbar puncture opening pressure (210.86 vs. 241.12 mmH₂O, P=0.006), and a smaller mean stenosis pressure gradient (1.98 vs. 3.72 mmHg, P=0.004) than those in Group B after surgery. No statistically significant differences were detected in the complication rates between the two groups (7.8% vs. 10.3%, P=0.755).

Compared with stenting, balloon angioplasty alone had limited short-term efficacy and unsatisfactory long-term results. Consequently, it is not recommended as a first-line treatment of IIH and VSS but rather as a complementary or adjunctive therapy to stenting.