{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:10:40Z","timestamp":1792649440709,"version":"4.5.0"},"reference-count":25,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2018,5,10]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The relationship between degree of angiographic venous sinus stenosis and the trans-stenosis pressure gradient magnitude in idiopathic intracranial hypertension (IIH) is poorly understood. The present study aimed to assess the utility of angiography, venography, and non-invasive imaging (MRV or CTV) for the diagnosis and characterization of clinically significant VSS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective analysis of a prospectively collected database was performed to identify patients with medically refractory IIH who were evaluated by angiography and venous manometry for the presence of VSS with associated clinically significant pressure gradient. Angiographic stenosis was measured by two independent raters using novel methodology.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty-seven patients met inclusion criteria for the study. In total, 70% of patients had clinically significant pressure gradients and were selected for stenting. The optimal percentage stenosis for detection of a significant pressure gradient was 34% stenosis on venous phase arteriography (sensitivity 0.81 and specificity 0.91) and 31% stenosis on venography (0.92 and 0.73). For every 10% increase in stenosis, an approximate increase in pressure gradient of 3.5\u2009mmHg is seen. MRV\/CTV had a calculated sensitivity of 0.42, and a negative predictive value of 22%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The degree of stenosis predictive of a clinically significant pressure gradient (30\u201335%) in the venous sinuses is considerably lower than the arterial stenosis at which pathologic hemodynamic alterations occur. While highly predictive of a venous pressure gradient when a stenosis is identified, non-invasive imaging does not appear to be a suitable diagnostic evaluation for the purpose of ruling out clinically significant cerebral VSS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2018-014004","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T12:25:05Z","timestamp":1527855905000},"page":"90-94","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":59,"title":["Correlation between angiographic stenosis and physiologic venous sinus outflow obstruction in idiopathic intracranial hypertension"],"prefix":"10.1136","volume":"11","author":[{"given":"James L","family":"West","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garret P","family":"Greeneway","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8483-1482","authenticated-orcid":false,"given":"Rebecca M","family":"Garner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A","family":"Aschenbrenner","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Biostatistics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey Q","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8979-1993","authenticated-orcid":false,"given":"Kyle M","family":"Fargen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,6,1]]},"reference":[{"key":"2025092913152965000_11.1.90.1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.12.1662"},{"key":"2025092913152965000_11.1.90.2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1890"},{"key":"2025092913152965000_11.1.90.3","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2575"},{"key":"2025092913152965000_11.1.90.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2010.11.012"},{"key":"2025092913152965000_11.1.90.5","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2011-010156"},{"key":"2025092913152965000_11.1.90.6","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827debd6"},{"key":"2025092913152965000_11.1.90.7","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.3171\/2016.8.JNS16879","article-title":"Venous sinus stenting for reduction of intracranial pressure in IIH: a prospective pilot study","volume":"127","author":"Liu","year":"2017","journal-title":"J Neurosurg"},{"key":"2025092913152965000_11.1.90.8","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1097\/WNO.0000000000000426","article-title":"Venous sinus stenting in idiopathic intracranial hypertension: results of a prospective trial","volume":"37","author":"Dinkin","year":"2017","journal-title":"J Neuroophthalmol"},{"key":"2025092913152965000_11.1.90.9","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s00234-017-1783-5","article-title":"Endovascular treatment of idiopathic intracranial hypertension: retrospective analysis of immediate and long-term results in 51 patients","volume":"59","author":"Aguilar-P\u00e9rez","year":"2017","journal-title":"Neuroradiology"},{"key":"2025092913152965000_11.1.90.10","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-011692"},{"key":"2025092913152965000_11.1.90.11","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2013-010691"},{"key":"2025092913152965000_11.1.90.12","doi-asserted-by":"crossref","unstructured":"West JL , Garner RM , Greeneway GP , et al . Venous waveform morphological changes associated with treatment of symptomatic venous sinus stenosis. J Neurointerv Surg 2018. doi: 10.1136\/neurintsurg-2018-013858. [Epub ahead of print: 21 Mar 2018].doi:10.1136\/neurintsurg-2018-013858","DOI":"10.1136\/neurintsurg-2018-013858"},{"key":"2025092913152965000_11.1.90.13","first-page":"60","article-title":"Iliac vein stenting for chronic venous insufficiency","volume":"34","author":"Mussa","year":"2007","journal-title":"Tex Heart Inst J"},{"key":"2025092913152965000_11.1.90.14","doi-asserted-by":"crossref","DOI":"10.1136\/neurintsurg-2014-011606.rep","article-title":"Reversible transverse sinus collapse in a patient with idiopathic intracranial hypertension","volume":"8","author":"Onder","year":"2016","journal-title":"J Neurointerv Surg"},{"key":"2025092913152965000_11.1.90.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainresrev.2004.04.005"},{"key":"2025092913152965000_11.1.90.16","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1161\/01.RES.49.4.988","article-title":"Flow through collapsible tubes at high Reynolds numbers","volume":"49","author":"Lyon","year":"1981","journal-title":"Circ Res"},{"key":"2025092913152965000_11.1.90.17","doi-asserted-by":"crossref","unstructured":"Buell TJ , Raper DMS , Pomeraniec IJ , et al . Transient resolution of venous sinus stenosis after high-volume lumbar puncture in a patient with idiopathic intracranial hypertension. J Neurosurg 2017:1\u20134.doi:10.3171\/2017.3.JNS163181","DOI":"10.3171\/2017.3.JNS163181"},{"key":"2025092913152965000_11.1.90.18","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1002\/ar.23370","article-title":"Anatomical variations of the transverse-sigmoid sinus junction: implications for endovascular treatment of idiopathic intracranial hypertension","volume":"299","author":"McCormick","year":"2016","journal-title":"Anat Rec"},{"key":"2025092913152965000_11.1.90.19","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.121127"},{"key":"2025092913152965000_11.1.90.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(03)01020-6"},{"key":"2025092913152965000_11.1.90.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.02.062"},{"key":"2025092913152965000_11.1.90.22","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e31827f18eb"},{"key":"2025092913152965000_11.1.90.23","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1227\/NEU.0000000000001261","article-title":"Stenting of the lateral sinus in idiopathic intracranial hypertension according to the type of stenosis","volume":"80","author":"Lenck","year":"2017","journal-title":"Neurosurgery"},{"key":"2025092913152965000_11.1.90.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2014.09.015"},{"key":"2025092913152965000_11.1.90.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2014.10.012"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2018-014004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:15:38Z","timestamp":1759176938000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2018-014004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,1]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12,17]]},"published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1136\/neurintsurg-2018-014004"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2018-014004","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,1]]}}}