Document resource
Background and Purpose Transverse sinus stenosis (TSS) is increasingly recognised as a treatable cause of pulsatile tinnitus (PT) and headache, both in the context of idiopathic intracranial hypertension (IIH) and in isolation. Venous sinus stenting (VSS) has demonstrated efficacy in IIH, yet its impact in non-IIH TSS populations remains incompletely characterised. This study evaluates physiological and clinical outcomes following VSS in a single-centre cohort, with IIH subgroup analysis.Materials and Methods A retrospective analysis was performed on adults (≥18 years) who underwent VSS for symptomatic TSS between January 2022 and February 2025 at a tertiary neurointerventional centre. Pre- and post-procedural transvenous manometry was recorded for all patients. Primary outcomes were venous pressure gradient reduction and PT/headache status at first outpatient follow-up (median 69 days). Subgroup analysis compared patients with and without a formal IIH diagnosis.Results Seventy-five patients (93% female; median age 33, BMI 29) underwent VSS. Technical success was achieved in all cases. Median venous pressure gradient decreased from 15 mmHg (range 6-21) pre-procedurally to 2 mmHg (0-5) post-procedurally (Z = −7.529, p < 0.001; rank-biserial r = −1.0), with durable reduction at follow-up (2 mmHg [0-14]; Z = −7.454, p < 0.001). Ninety percent of patients presenting with PT (54/60) and 72% presenting with headache (33/46) achieved resolution or improvement at follow-up. Restenosis and reintervention rates were 9% and 8%, respectively. In subgroup analysis, non-IIH patients demonstrated significantly lower post-procedural (2 vs 4 mmHg; p < 0.05) and follow-up (2 vs 3 mmHg; p < 0.05) pressure gradients compared to IIH patients, with no significant difference in symptomatic outcomes between groups.Conclusions VSS for symptomatic TSS achieves significant, durable haemodynamic improvement and high rates of PT and headache resolution regardless of IIH status. Non-IIH patients demonstrate superior haemodynamic response, potentially reflecting a more unifactorial aetiology. These findings support VSS as a viable treatment for both IIH-associated and isolated symptomatic TSS and underscore the need for prospective trials to refine patient selection and optimise long-term outcomes.Disclosures Y. Wardak: None. S. Naderi: None. A. Daneshi: None. S. Khalilollah: None. R. Chandra: None. P. Smith: None. J. Maingard: None. A. Khabaza: None. D. Pavlin-Premrl: None. A. Jhamb: None. M. Brooks: None. J. Russell: None. A. Gonzalvo: None. L. Slater: None. C. Gan: None. J. Moore: None. A. Gauden: None. C. Barras: None. H. Kok: None. B. Shaygi: None. N. Kutaiba: None. M. Stewart: None. H. Asadi: None.Abstract E-206 Figure 1