机构：[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China神经科系统神经内科首都医科大学宣武医院[2]Advanced Center of Stroke, Beijing Institute for BrainDisorders, Beijing, China[3]Department of China-America Institute of Neuroscience, Xuanwu Hospital, CapitalMedical University, Beijing, China科技平台中美神经科学研究所首都医科大学宣武医院[4]Department of Neurosurgery, Xuanwu Hospital, CapitalMedical University, Beijing, China神经科系统神经外科首都医科大学宣武医院[5]Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
Background: Cerebral venous sinus (CVS) stenting has been widely applied for correcting CVS stenosis. However, there are still some potential complications. The purpose of this study is to investigate the impact of perioperative management on avoiding complications of CVS stenting. Methods: Patients confirmed as CVS stenosis were enrolled from January 2014 through November 2019. All CVS stenosis were corrected by stenting when the trans-stenotic mean pressure gradient (MPG) was up to or over 8 mmHg. Patients were divided into perioperative management group and control group. Patients in the former group underwent transiently mannitol 250 mL intravenous infusion immediately prior to stenting besides routine ICP control. While patients in control group underwent the same routine treatment as in the perioperative management group. The clinical symptoms, intracranial pressure (ICP), and MPG of the patients were compared before and after stenting. In addition, the complications between the two groups were compared. Results: A total of 81 eligible patients were finally enrolled in this study, including 64 females and 17 males, mean aged 45.35 +/- 13.83 years. After stenting, the stenotic CVS restored normal blood flow and MPG decreased significantly [10.0 (8.0-15.0) vs. 0.0 (0.0-0.7) mmHg, P<0.001]. Headache, tinnitus, visual impairment, visual loss, Frisen papilledema grade (FPG), and ICP were ameliorated immediately (P<0.001) in the majority of patients in the two groups. However, the incidence of intracranial hemorrhage was higher in control group (11.4% vs. 0.0%, P=0.031). Conclusions: A transiently strict preoperative ICP control by mannitol may inhibit CVS stenting-related hemorrhage, which makes the stenting safer and more effective on correcting the CVS stenosis.
基金：
National Key R&D Program of China [2017YFC1308401]; National Natural Science FoundationNational Natural Science Foundation of China [81371289]; Project of Beijing Municipal Top Talent for Healthy Work of China [2014-2-015]
第一作者机构：[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China[2]Advanced Center of Stroke, Beijing Institute for BrainDisorders, Beijing, China[3]Department of China-America Institute of Neuroscience, Xuanwu Hospital, CapitalMedical University, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[*1]Department of Neurology, Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
Chaobo Bai,Jian Chen,Xiaoqin Wu,et al.Perioperative mannitol intensive use may avoid the early complication of cerebral venous sinus stenting[J].ANNALS OF TRANSLATIONAL MEDICINE.2020,8(11):doi:10.21037/atm-20-3021.
APA：
Chaobo Bai,Jian Chen,Xiaoqin Wu,Yuchuan Ding,Xunming Ji&Ran Meng.(2020).Perioperative mannitol intensive use may avoid the early complication of cerebral venous sinus stenting.ANNALS OF TRANSLATIONAL MEDICINE,8,(11)
MLA：
Chaobo Bai,et al."Perioperative mannitol intensive use may avoid the early complication of cerebral venous sinus stenting".ANNALS OF TRANSLATIONAL MEDICINE 8..11(2020)
