Long-Term Outcomes of Stenting for Pulsatile Tinnitus Caused by Cerebral Venous Sinus Stenosis

Abstract

Objective: To investigate the long-term outcomes of stenting for isolated pulsatile tinnitus (PT) caused by cerebral venous sinus stenosis.

Study design: Retrospective study.

Setting: The First Medical Center, Chinese PLA General Hospital.

Patients: Patients diagnosed to have isolated PT secondary to cerebral venous sinus stenosis at our institution between December 2009 and March 2023.

Intervention: Cerebral venous sinus stenting.

Main outcome measures: Morphological features of the cerebral venous sinus, endovascular technique, and clinical outcomes.

Results: The study included 80 patients with a mean age of 39.4 ± 9.6 years and an average body mass index of 23.9 kg/m. The mean age at symptom onset was 35.1 ± 8.7 years. Seventy-five of the patients (93.8%) were women. PT was the primary symptom. All patients reported feeling anxious because PT had severely affected their day-to-day lives. The PT was right-sided in 52 cases (65%). All procedures were technically successful. The mean trans-stenotic pressure gradient decreased from 4.3 ± 3.3 mm Hg before stenting to 0.4 ± 0.9 mm Hg after stent placement. Twenty-one patients (26.3%) experienced poststenting headache. The mean follow-up duration was 80.5 ± 46.3 months, with 26 patients followed for over 120 months. PT resolved in all cases after stenting, and there were no recurrences. Follow-up radiographic examination of 23 patients (28.8%) at a mean of 71.2 ± 43.1 months identified only one case of restenosis.

Conclusions: Long-term follow-up of these patients confirmed the efficacy and safety of stenting for isolated venous sinus stenosis-related PT.