Shunting,optic nerve sheath fenestration and dural venous stenting for medically refractory idiopathic intracranial hypertension:systematic review and meta-analysis

作     者：Daniel B.Scherman Adam A.Dmytriw Gia Thanh Nguyen Nhan Thi Nguyen Nana Tchantchaleishvili Julian Maingard Hamed Asadi Mark Brooks Christoph Griessenauer Christopher Ogilvy Ajith J.Thomas Justin M.Moore Kevin Phan 

作者机构：NeuroSpine Surgery Research Group(NSURG)Prince of Wales Private HospitalSydneyAustralia Department of NeurosurgeryBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA Hue University of Medicine and PharmacyHue CityVietnam University of Medicine and PharmacyHo Chi Minh CityVietnam Interventional Neuroradiology ServiceDepartment of RadiologyAustin HospitalMelbourneAustralia Interventional Neuroradiology UnitMonash ImagingMonash HealthMelbourneAustralia Faculty of HealthSchool of MedicineDeakin UniversityWaurn PondsAustralia Department of NeurosurgeryGeisinger Health SystemDanvilleUSA Department of NeurosurgeryStanford UniversityStanfordUSA 

出 版 物：《Annals of Eye Science》 (眼科学年鉴（英文）)

年 卷 期：2018年第3卷第1期

页      面：169-183页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Cerebrospinal fluid diversion procedures(CSF-diversion procedures) idiopathic intracranial hypertension(IIH) optic nerve sheath fenestration(ONSF) venous sinus stent placement(VSS) 

摘      要：Background:Cerebrospinal fluid(CSF)-diversion procedures have traditionally been the standard of treatment for patients with medically refractive idiopathic intracranial hypertension(IIH).However,dural venous sinus stent(VSS)placement has been described as a safe and effective procedure for the management of medically refractive *** performed a meta-analysis comparing outcomes and complications of CSF-diversion procedures,VSS and optic nerve sheath fenestration(ONSF)for the treatment of medically refractive ***:Electronic searches were performed using six databases from 1988 to January *** was extracted and meta-analysed from the identified ***:From 55 pooled studies,there were 538 CSF-diversion cases,224 dural venous stent placements,and 872 ONSF *** improvements were found in terms of postoperative headaches(CSF *** ***:84%vs.78%vs.62%,P=0.223),papilledema(CSF *** ***:71%vs.86%vs.77%,P=0.192),whilst visual acuity changes favored venous stenting(CSF *** ***:55%vs.69%vs.44%,P=0.037).There was a significantly lower rate of subsequent procedures with venous stent placement(CSF *** ***:37%vs.13%vs.18%,P0.001),but other complication rates were similar(CSF *** ***:13%vs.8%vs.14%,P=0.28).Subgroup analysis of lumbar-peritoneal *** shunts found no differences in symptom improvements,complications and subsequent procedure ***:Our findings suggest that dural venous sinus stenting may be a viable alternative to traditional surgical interventions in patients who are refractory to medical treatment.