{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T03:02:38Z","timestamp":1784862158869,"version":"3.55.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Port Said University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pulsatile tinnitus (PT) can emerge due to stenosis in the venous sinus, which leads to turbulent venous flows and increased pressures within the veins. Stenting of the venous sinus (VSS) is a potential intervention to relieve PT and is considered minimally invasive, as it restores proper venous flow. To evaluate the clinical, hemodynamic, and radiological outcomes of venous sinus stenting (VSS) in a real-world cohort of patients with pulsatile tinnitus (PT) and venous sinus stenosis, and to describe the symptom\u2013imaging\u2013manometry framework used for procedural selection in routine practice. From January 2018 to December 2024, we conducted a dual-center, retrospective cohort study of 30 consecutive adults with PT who underwent transverse sinus stenting. Secondary outcomes included changes in trans-stenotic venous pressure gradient, early 1-month change in LP opening pressure, radiologic resolution, papilledema improvement, procedure-related complications, and recurrence. Thirty patients were included (28 females; mean age 39.0\u2009\u00b1\u200913.1 years). PT was right-sided in 50.0%, left-sided in 16.7%, and bilateral in 33.3%. Mean pre-stent trans-stenotic pressure gradient was 7.0\u2009\u00b1\u20091.4 mmHg and decreased significantly after stenting (P\u2009&lt;\u20090.001). LP opening pressure decreased from 39.93\u2009\u00b1\u200910.99 before stenting to 18.23\u2009\u00b1\u20093.87 cm H\u2082O at 1 month after stenting (P\u2009&lt;\u20090.001). Immediate complete symptom resolution occurred in 27 patients (90%); the remaining 3 patients (10%) achieved complete resolution by 12 months of follow-up. Follow-up MRV demonstrated resolution of the treated venous sinus stenosis, with restored sinus caliber\/patency in all patients. Minor complications occurred in 3 patients (10%) (ecchymosis 6.7%, epistaxis 3.3%), with no major adverse events or recurrence. VSS was associated with a significant reduction in venous pressure gradient and LP opening pressure, along with high durable PT resolution rates and a low rate of minor complications in this cohort.<\/jats:p>","DOI":"10.1007\/s10143-026-04412-9","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T02:50:49Z","timestamp":1784861449000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Venous sinus stenting for pulsatile tinnitus secondary to venous sinus stenosis: a dual-center retrospective cohort study"],"prefix":"10.1007","volume":"49","author":[{"given":"Amr Abu","family":"Elfadle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1739-0597","authenticated-orcid":false,"given":"Mohamed S.","family":"Hemeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Abd ELRhman","family":"Elassy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Salah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Nada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Reda Abd El aziz","family":"Zaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Elghareeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"issue":"5","key":"4412_CR1","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1097\/MOO.0b013e3283493fd8","volume":"19","author":"A Sismanis","year":"2011","unstructured":"Sismanis A (2011) Pulsatile tinnitus: contemporary assessment and management. Curr Opin Otolaryngol Head Neck Surg 19(5):348\u2013357","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"7\u20138","key":"4412_CR2","first-page":"415","volume":"98","author":"S Lenck","year":"2017","unstructured":"Lenck S, Labeyrie MA, Houdart E, Boukobza M (2017) Pulsatile tinnitus: imaging and differential diagnosis. Diagn Interv Imaging 98(7\u20138):415\u2013426","journal-title":"Diagn Interv Imaging"},{"issue":"8","key":"4412_CR3","first-page":"1635","volume":"27","author":"A Krishnan","year":"2006","unstructured":"Krishnan A, Mattox DE, Fountain AJ, Hudgins PA (2006) CT arteriography and venography in pulsatile tinnitus: preliminary results. AJNR Am J Neuroradiol 27(8):1635\u20131638","journal-title":"AJNR Am J Neuroradiol"},{"issue":"3","key":"4412_CR4","first-page":"592","volume":"28","author":"YD Cho","year":"2007","unstructured":"Cho YD, Lee JY, Seo JH, Kang HS, Cho SH (2007) CT venography in pulsatile tinnitus: emphasis on sinus wall abnormalities. AJNR Am J Neuroradiol 28(3):592\u2013597","journal-title":"AJNR Am J Neuroradiol"},{"issue":"10","key":"4412_CR5","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1212\/01.WNL.0000125285.44539.D7","volume":"62","author":"JNP Higgins","year":"2004","unstructured":"Higgins JNP, Pickard JD (2004) Lateral sinus stenoses in idiopathic intracranial hypertension resolving after CSF diversion. Neurology 62(10):1907\u20131908","journal-title":"Neurology"},{"issue":"9","key":"4412_CR6","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.1212\/01.WNL.0000066683.34093.E2","volume":"60","author":"RI Farb","year":"2003","unstructured":"Farb RI, Vanek I, Scott JN, Mikulis DJ, Willinsky RA, Tomlinson G et al (2003) Idiopathic intracranial hypertension: prevalence and morphology of sinovenous stenosis. Neurology 60(9):1418\u20131424","journal-title":"Neurology"},{"issue":"4","key":"4412_CR7","first-page":"632","volume":"26","author":"B Li","year":"2016","unstructured":"Li B, Lv X, Wu Z, Cao X, Wang J, Ge A et al (2016) Stent-assisted coil embolization of a transverse-sigmoid sinus diverticulum presenting with pulsatile tinnitus. Turk Neurosurg 26(4):632\u2013634","journal-title":"Turk Neurosurg"},{"issue":"6","key":"4412_CR8","first-page":"953","volume":"26","author":"B Li","year":"2016","unstructured":"Li B, Lv X, Wu Z, Cao X, Wang J, Ge A et al (2016) Occult pulsatile tinnitus in association with a prominent vein of the hypoglossal canal: two case reports. Turk Neurosurg 26(6):953\u2013956","journal-title":"Turk Neurosurg"},{"issue":"4","key":"4412_CR9","first-page":"372","volume":"10","author":"NS Patel","year":"2018","unstructured":"Patel NS, Binkley EM, Katz JS, Liao E, Olson S, Hsu FPK (2018) Venous sinus stenting for pulsatile tinnitus associated with venous sinus stenosis: a single-center experience. J Neurointerv Surg 10(4):372\u2013378","journal-title":"J Neurointerv Surg"},{"issue":"6","key":"4412_CR10","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.3174\/ajnr.A5108","volume":"38","author":"AH Liu","year":"2017","unstructured":"Liu AH, Dinkin M, Matouk CC, Boddu S, Brown RD Jr, Farb RI (2017) Resolution of pulsatile tinnitus after venous sinus stenting in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 38(6):1141\u20131147. https:\/\/doi.org\/10.3174\/ajnr.A5108","journal-title":"AJNR Am J Neuroradiol"},{"issue":"2","key":"4412_CR11","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1177\/1591019920974185","volume":"27","author":"A Patsalides","year":"2021","unstructured":"Patsalides A, Santillan A, Sundararajan SH, Michael M, Suurna M, Alexiades G (2021) Venous sinus stenting for the treatment of isolated pulsatile tinnitus: results of a prospective trial. Interv Neuroradiol 27(2):266\u2013274. https:\/\/doi.org\/10.1177\/1591019920974185","journal-title":"Interv Neuroradiol"},{"issue":"5","key":"4412_CR12","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1227\/neu.0000000000002095","volume":"91","author":"ME Inam","year":"2022","unstructured":"Inam ME, Martinez-Gutierrez JC, Kole MJ, Sanchez F, Lekka E, Truong VTT et al (2022) Venous sinus stenting for low-pressure gradient stenoses in idiopathic intracranial hypertension. Neurosurgery 91(5):734\u2013740. https:\/\/doi.org\/10.1227\/neu.0000000000002095","journal-title":"Neurosurgery"},{"issue":"12","key":"4412_CR13","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1136\/neurintsurg-2018-014042","volume":"10","author":"KM Fargen","year":"2018","unstructured":"Fargen KM, Liu K, Garner RM, Greeneway GP, Wolfe SQ, Crowley RW (2018) Recommendations for the selection and treatment of patients with idiopathic intracranial hypertension for venous sinus stenting. J Neurointerv Surg 10(12):1203\u20131208. https:\/\/doi.org\/10.1136\/neurintsurg-2018-014042","journal-title":"J Neurointerv Surg"},{"key":"4412_CR14","doi-asserted-by":"publisher","first-page":"e992","DOI":"10.1016\/j.wneu.2024.08.048","volume":"190","author":"D Schartz","year":"2024","unstructured":"Schartz D, Finkelstein AJ, Akkipeddi SMK, Williams Z, Vates E, Bender MT (2024) Outcomes of pulsatile tinnitus after cerebral venous sinus stenting: systematic review and pooled analysis of 616 patients. World Neurosurg 190:e992\u2013e999","journal-title":"World Neurosurg"}],"container-title":["Neurosurgical Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-026-04412-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10143-026-04412-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-026-04412-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T02:50:51Z","timestamp":1784861451000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10143-026-04412-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4412"],"URL":"https:\/\/doi.org\/10.1007\/s10143-026-04412-9","relation":{},"ISSN":["1437-2320"],"issn-type":[{"value":"1437-2320","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"assertion":[{"value":"5 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was reviewed and approved by the Research Ethics Committee, Faculty of Medicine, Port Said University, Egypt (ERN: MED (1\/06\/2025); Serial No. 296; NUS_003; approval date: June 2025). The requirement for informed consent was waived due to the retrospective design and the analysis of anonymized data.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This is a retrospective observational cohort study; no participants were prospectively assigned to an intervention for research purposes.","order":4,"name":"Ethics","label":"Clinical trial registration","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"493"}}