Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension
Abstract The value of intravascular ultrasound (IVUS) in the diagnosis and treatment of the venous system is not well established. Introducing a novel approach to utilizing IVUS to evaluate cerebral venous sinus (CVS) stenosis and select stent. Idiopathic intracranial hypertension (IIH) patients wit...
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Nature Portfolio
2025-05-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-00505-5 |
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| author | Gang Luo Raynald Xu Tong Yinuo Huang Zifei Han Dapeng Sun Bo Wang Baixue Jia Zhenbo Shi Feng Gao Ning Ma Zhongrong Miao Dapeng Mo |
| author_facet | Gang Luo Raynald Xu Tong Yinuo Huang Zifei Han Dapeng Sun Bo Wang Baixue Jia Zhenbo Shi Feng Gao Ning Ma Zhongrong Miao Dapeng Mo |
| author_sort | Gang Luo |
| collection | DOAJ |
| description | Abstract The value of intravascular ultrasound (IVUS) in the diagnosis and treatment of the venous system is not well established. Introducing a novel approach to utilizing IVUS to evaluate cerebral venous sinus (CVS) stenosis and select stent. Idiopathic intracranial hypertension (IIH) patients with CVS stenosis who underwent IVUS-guided stenting were included in the data analysis from January 2014 to February 2022. The degree of maximum stenosis was determined based on the cross-sectional area (CSA) measured by IVUS, and a stent selection method was applied in the study. Follow-up evaluations were conducted at 6 months to 1 year after endovascular treatment to assess symptom improvement. Additionally, repeated digital subtraction angiography (DSA) or Magnetic resonance venography (MRV) / CT venography（CTV） was performed to evaluate the stent patency at 6 months to 1 year post-procedure. The study included 61 patients. IVUS indicated a lower degree of stenosis compared to conventional DSA measurements when evaluating the degree of stenotic segments preprocedure (74.84 ± 10.12% vs. 78.48 ± 8.72%, p = 0.035). Post-procedural CSA of the most severe stenotic segments showed significant improvement (36.44 ± 8.07 mm2 vs. 7.42 ± 3.28 mm2, p < 0.001). The stent achieved complete expansion (mean stent expansion index, 0.93 ± 0.20) with no significant change in the structure of the reference segment. The trans-stenotic mean pressure gradients (MPGs) across 61 patients significantly decreased from 11.00 ± 6.23 mmHg to 2.09 ± 2.34 mmHg. 47 out of 61 patients received imaging follow-up; among them, 44 (93.6%) demonstrated stent patency in the follow-up imaging. IVUS has great potential to evaluate the degree and extent of CVS stenosis, assist stent selection, and optimize stent position during the interventional procedure in conjunction with DSA. |
| format | Article |
| id | doaj-art-b7adc18fdea34396b03cc98a353b45ec |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-b7adc18fdea34396b03cc98a353b45ec2025-08-20T02:32:01ZengNature PortfolioScientific Reports2045-23222025-05-0115111010.1038/s41598-025-00505-5Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertensionGang Luo0Raynald1Xu Tong2Yinuo Huang3Zifei Han4Dapeng Sun5Bo Wang6Baixue Jia7Zhenbo Shi8Feng Gao9Ning Ma10Zhongrong Miao11Dapeng Mo12Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Medicine, Beijing Fengtaiyouanmen HospitalUniversity of International Business and EconomicsDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical UniversityAbstract The value of intravascular ultrasound (IVUS) in the diagnosis and treatment of the venous system is not well established. Introducing a novel approach to utilizing IVUS to evaluate cerebral venous sinus (CVS) stenosis and select stent. Idiopathic intracranial hypertension (IIH) patients with CVS stenosis who underwent IVUS-guided stenting were included in the data analysis from January 2014 to February 2022. The degree of maximum stenosis was determined based on the cross-sectional area (CSA) measured by IVUS, and a stent selection method was applied in the study. Follow-up evaluations were conducted at 6 months to 1 year after endovascular treatment to assess symptom improvement. Additionally, repeated digital subtraction angiography (DSA) or Magnetic resonance venography (MRV) / CT venography（CTV） was performed to evaluate the stent patency at 6 months to 1 year post-procedure. The study included 61 patients. IVUS indicated a lower degree of stenosis compared to conventional DSA measurements when evaluating the degree of stenotic segments preprocedure (74.84 ± 10.12% vs. 78.48 ± 8.72%, p = 0.035). Post-procedural CSA of the most severe stenotic segments showed significant improvement (36.44 ± 8.07 mm2 vs. 7.42 ± 3.28 mm2, p < 0.001). The stent achieved complete expansion (mean stent expansion index, 0.93 ± 0.20) with no significant change in the structure of the reference segment. The trans-stenotic mean pressure gradients (MPGs) across 61 patients significantly decreased from 11.00 ± 6.23 mmHg to 2.09 ± 2.34 mmHg. 47 out of 61 patients received imaging follow-up; among them, 44 (93.6%) demonstrated stent patency in the follow-up imaging. IVUS has great potential to evaluate the degree and extent of CVS stenosis, assist stent selection, and optimize stent position during the interventional procedure in conjunction with DSA.https://doi.org/10.1038/s41598-025-00505-5Cerebral venous sinusIntravascular ultrasoundDigital Subtraction angiography |
| spellingShingle | Gang Luo Raynald Xu Tong Yinuo Huang Zifei Han Dapeng Sun Bo Wang Baixue Jia Zhenbo Shi Feng Gao Ning Ma Zhongrong Miao Dapeng Mo Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension Scientific Reports Cerebral venous sinus Intravascular ultrasound Digital Subtraction angiography |
| title | Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension |
| title_full | Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension |
| title_fullStr | Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension |
| title_full_unstemmed | Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension |
| title_short | Real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension |
| title_sort | real time intravascular ultrasound evaluation and stent selection for cerebral venous sinus stenosis associated with idiopathic intracranial hypertension |
| topic | Cerebral venous sinus Intravascular ultrasound Digital Subtraction angiography |
| url | https://doi.org/10.1038/s41598-025-00505-5 |
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