Evidence map›Paper›PMID 40579154›Full record

ArticleJournal of neurointerventional surgery2026

Transverse venous sinus stenting versus cerebrospinal fluid shunting in idiopathic intracranial hypertension: a multi-institutional and multinational database study.

Jarunee Intrapiromkul, Ansaar T Rai, Dhairya A Lakhani

Abstract readMulticenter StudyComparative Study
In one paragraph

Article in Journal of neurointerventional surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Jarunee IntrapiromkulDepartment of Neuroradiology, WVU Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA.
Ansaar T RaiDepartment of Neuroradiology, WVU Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA.ORCID http://orcid.org/0000-0001-9864-4805
Dhairya A LakhaniDepartment of Neuroradiology, WVU Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA dhairyalakhani@gmail.com.ORCID http://orcid.org/0000-0001-7577-1887

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Laura F. Gibson · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundCerebrospinal fluid (CSF) shunting and transverse venous sinus (TVS) stenting are promising treatment choices for idiopathic intracranial hypertension (IIH), addressing different aspects of IIH pathophysiology. However, large-scale comparative data remain limited.

methodsWe performed a multinational, multi-institutional, retrospective propensity score-matched analysis using the TriNetX platform. Adult patients diagnosed with IIH who underwent either TVS stenting or CSF shunting were included. The primary outcome was treatment failure, defined as the need for subsequent procedures (repeat TVS stenting, CSF shunt, or optic nerve fenestration). Secondary outcomes included residual symptoms (headache, visual disturbances, dizziness, and pulsatile tinnitus), ongoing use of IIH-related medications (furosemide, acetazolamide, and topiramate), and healthcare utilization, assessed through unplanned hospital readmissions and emergency department (ED) visits at 1 year follow-up.

resultsOf 134 530 IIH patients identified, 1362 underwent TVS stenting and 5278 underwent CSF shunting. After propensity score matching, patients who received TVS stenting had significantly lower odds of repeat interventions (9.6% vs 38.6%; OR 0.169, 95% CI 0.136 to 0.212, P<0.001). They also had significantly lower odds of residual headache, visual disturbances, and papilledema. However, stenting was associated with higher odds of persistent pulsatile tinnitus (6.7% vs 2.2%; OR 3.183, P<0.001). TVS stenting was associated with lower odds of unplanned inpatient readmissions (24.1% vs 40.5%; OR 0.466, P<0.001) and ED visits (22.0% vs 34.0%; OR 0.548, P<0.001).

conclusionBoth TVS stenting and CSF shunting resulted in symptomatic improvement and reduced medication use in patients with IIH. However, stenting was associated with significantly lower treatment failure rates, fewer residual papilledema, headaches and visual symptoms, and reduced healthcare utilization. Persistent pulsatile tinnitus was more common following stenting.

Indexed as

Cerebrospinal Fluid ShuntsPseudotumor CerebriStentsTransverse SinusesAdultDatabases, FactualFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeIntracranial PressureStent

Identifiers

PMID40579154
PMCPMC12287911

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.