Counterpoint: stenting for idiopathic intracranial hypertension should be trialed

We have an obligation to our patients to prove that what we do works—that the benefits of our procedures outweigh their risks. That evidence base is notably lacking for dural sinus stenting for patients with idiopathic intracranial hypertension (IIH). We do not dispute that many patients with IIH have a pressure gradient in their dural sinuses, typically due to what is almost certainly extrinsic compression of their transverse sinuses.1 Stenting of these patients reduces central venous and intracranial pressure, conclusively and dramatically.2 This is generally accompanied by improvement in many of the symptoms reported by these patients.3 We also do not dispute that it is reasonable to offer stenting to some patients, but with the caveat that the evidence regarding many aspects of this procedure is weak. There is a long list of unanswered questions regarding venous sinus stenting for patients with IIH....
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Commentary Source Type: research