Venous sinus stenting in idiopathic intracranial hypertension: a systematic review of an emerging intervention with favorable outcomes but unresolved standardization

Dural venous sinus stenosis is increasingly implicated in idiopathic intracranial hypertension (IIH), and venous sinus stenting (VSS) has emerged as a therapeutic option. Current evidence is observational and based almost exclusively on off-label stent platforms.

Venous sinus stenting shows favorable outcomes for IIH-related pulsatile tinnitus and hearing symptoms, but lack of standardized patient-selection criteria and procedural protocols means audiologists should refer IIH cases to specialist neurology/neurosurgery teams rather than adjust their own practice.

IIH is an under-recognised cause of pulsatile tinnitus and low-frequency hearing changes seen in audiology clinics, and emerging surgical options may benefit these patients if standardisation improves.

1. 01Venous sinus stenting is an emerging intervention for idiopathic intracranial hypertension (IIH) caused by dural venous sinus stenosis.
2. 02Systematic review finds generally favorable outcomes, but study heterogeneity limits firm conclusions.
3. 03No standardised criteria exist for patient selection, stent sizing, or post-procedure management.
4. 04IIH can present with pulsatile tinnitus and low-frequency hearing changes relevant to audiologists.
5. 05Further prospective, controlled trials are needed before this becomes standard of care.

PMID

42119726

DOI

10.1016/j.wneu.2026.125038.

Journal

World Neurosurgery

Publication type

meta_analysis

Evidence level

2a

Population

Patients with idiopathic intracranial hypertension secondary to dural venous sinus stenosis undergoing venous sinus stenting

Intervention

Venous sinus stenting for dural venous sinus stenosis in IIH