Abstract

Background: Idiopathic intracranial hypertension (IIH) is increasingly recognized as a disorder of impaired venous ou=low rather than isolated CSF dysregulaBon. Conventional management—medical therapy and CSF diversion—oEen fails to provide durable relief or address the underlying pathophysiology. Venous sinus stenBng (VSS) has emerged as a minimally invasive, pathophysiologically targeted treatment for patients with venous sinus stenosis and a demonstrable trans-stenotic pressure gradient.
Objecve: To present our clinical experience, procedural outcomes, and evolving insights into patient selection and hemodynamic assessment for venous sinus stenBng in IIH.
Methods: A retrospecBve review was conducted of paBents with IIH who underwent diagnosBc cerebral venography and manometry between [Feb 2023 – September2025]. PaBents demonstraBng ≥8 mmHg trans-stenoBc gradient underwent venous sinus stenBng using selfexpanding intracranial stents. Demographic data, pre- and post-procedural pressure measurements, papilledema grading, headache scores, and visual parameters were analysed. Procedural safety and clinical efficacy were evaluated at serial follow-ups.
Conclusion: Venous sinus stenting offers a durable and physiologically rational intervention for a subset of IIH patients with venous ou=low stenosis/obstruction. Careful hemodynamic assessment and multidisciplinary selection are key to optimizing outcomes. Ongoing prospective data and long-term follow-up are warranted to refine indications and establish standardized criteria for this evolving therapy