Transverse Sinus Stents for IIH: Treatment and Process

Fast facts:

• Venous stents are alloy mesh tubes placed in large central veins that keep the veins open and permit normal blood flow from the brain back to the heart.

• The procedure is minimally invasive, completed done while the patient is under general anaesthesia. Doctors will insert a sheath, into which follows a guidewire, catheter, and the stent.

What Is a Venous Stent?

Venous stents are alloy mesh tubes placed in larger central veins to keep the veins open to blood flow.

Patients diagnosed with IIH will have a scan of their venous sinuses, which are passageways that carry blood and cerebrospinal fluid from the brain to the heart. If the venous sinuses are narrowed, this causes a problem with the absorption of cerebrospinal fluid into the veins of the brain, and as a result, fluid pressure within the brain rises

The patient will then be referred to an interventional neurologist, a specialist that uses medical imaging tests to diagnose and treat diseases of the nervous system, head, neck, and spine. 

The interventional neurologist will determine if placing a venous stent can improve the condition.

Venous Sinus Stenting Procedure

One to two weeks before the procedure, the patient will be instructed to take blood thinners. At least 12 hours prior to the operation, the patient will need to fast.

The procedure is minimally invasive, and is done while the patient is under general anaesthesia. An inserted sheath allows entry of a guidewire, catheter, and delivery of the stent.

The stent is like a spring that is compressed so that it can enter into the vein. A guidewire is slipped into the vein with a balloon-tipped catheter, and then the compressed stent is delivered where the vein is blocked. The stent springs back to its normal size, forming into a circular tube that helps keep the vein from narrowing again.

Placing the stent is done with the help of advanced imaging that locates the diseased vessels and ensures the stent is safely positioned in the vein. 

Venous Sinus Stenting Post-Op Care

Post-surgery, the patient must refrain from lifting heavy objects or doing impact exercises like jogging and cycling for the first three days. 

Given that there is no excessive bruising, bleeding swelling, or pain on the wound, the patient may walk, climb steps, or even drive. Otherwise, please seek immediate medical attention.

While it’s okay to take a bath post-surgery, the patient should avoid soaking in the bathtub or pool until the wound is healed.

Patients will be discharged with a dressing on the wound; this may be removed the next day. When taking a bath, they must ensure to clean the wound with soap and let it dry. 

They will need to continue taking blood thinners for several months to prevent clots from forming on the stent and definitive instructions are given on the day of discharge.

They can go back to work usually one week after the procedure.

Side Effects of Venous Sinus Stenting

Post-operation, patients might feel a pulling sensation in the area where the stent is placed, but this is mainly caused by muscle spasms, not by the stent itself. 

A frontal headache is common on the same side of the stent for the first 48 hours and usually subsides with mild pain relief (such as paracetamol).

There may also be some bruising or discolouration on the puncture site for a few days after surgery. This is fairly common and should not be a cause of alarm. This will heal on its own. If the bruising is extensive, apply cold or warm packs on the bruised area. 

If there is swelling or pain associated with discolouration, seek medical attention immediately.

How Long Do Venous Stents Last?

Stents are designed with cutting-edge metal alloys usually constructed with nickel or titanium. They are inserted permanently and, with time, the vein grows into the stent. In rare instances, stents can be surgically removed.

Why Choose RPA for Venous Sinus Stenting

The Interventional Neurology at RPA is NSW’s specialist in supporting patients through their aneurysm, stroke, or neurological issue. 

As a public service, our consultation and treatments are zero-cost, covering everything from medication to surgery to recovery. 

Headquartered at Royal Prince Alfred Hospital in Sydney, we help patients across NSW with in-person and video-chat consultations.

Patient’s treatments can be supported across three disciplines — neurosurgery, neuroradiology and interventional neurology — all of whom can work together to get our patients the best outcome.

Patients with a referral from a GP are invited to book an appointment by clicking the button below or call us at +61 2 9515 6111.

DISCLAIMER: The information provided is designed to support, not replace, the relationship that exists between a patient or site visitor and their existing healthcare professionals.