Internal jugular vein stenting for symptomatic severe rotational stenosis

Area of Science:

• Neurology
• Vascular Surgery
• Interventional Radiology

Background:

• Dynamic internal jugular vein (IJV) stenosis is increasingly recognized in patients with cerebral venous outflow disorders (CVD).
• The role of dynamic jugular stenosis in disease progression remains undefined.
• This study evaluates IJV stenting for symptomatic rotational stenosis.

Purpose of the Study:

• To evaluate the safety and early outcomes of IJV stenting for symptomatic rotational stenosis.
• To assess the impact of IJV stenting on symptom severity and patient satisfaction.

Main Methods:

• Retrospective study of adult patients undergoing IJV stenting for dynamic, symptomatic IJV stenosis (2023-2025).
• Inclusion criteria: >75% rotational IJV stenosis on dynamic venography and ≥6 mmHg trans-stenotic pressure gradient.
• Symptom severity assessed using CVDSS and HIT-6 scales.

Main Results:

• Sixteen patients underwent successful IJV stent placement without complications.
• Median trans-stenotic pressure gradient improved from 7 mmHg to 1 mmHg post-stenting.
• Significant improvements in CVDSS (p<0.001) and HIT-6 (p<0.001) scores were observed, with sustained benefits at 10.1 months follow-up.
• 13 patients reported meaningful symptom improvement, and 88% were satisfied with the procedure.

Conclusions:

• Jugular vein stenting is technically feasible for refractory CVD patients with severe, symptomatic rotational IJV stenosis.
• The procedure is associated with meaningful clinical improvement, although partial symptom recurrence can occur.
• Optimal patient selection and procedural expertise are crucial for maximizing safety and efficacy.