Idiopathic Intracranial Hypertension (IIH)
Conditions
Keywords
Venous Sinus Stenosis, Venous Sinus Stenting, Papilledema, Middle East and North Africa (MENA), Magnetic Resonance Venography (MRV)
Brief summary
The VEHICLE Registry is a multicenter observational study aimed at evaluating the management and outcomes of patients with Idiopathic Intracranial Hypertension (IIH) undergoing venous sinus stenting in the Middle East and North Africa (MENA) region. The study focuses on assessing clinical characteristics, treatment efficacy, safety, and the role of venous sinus stenting as a therapeutic modality in IIH.
Detailed description
Idiopathic Intracranial Hypertension (IIH) is a condition characterized by elevated intracranial pressure without an identifiable cause, leading to symptoms such as headaches, visual disturbances, and potential vision loss due to papilledema. The condition predominantly affects obese women of childbearing age and is associated with risk factors like obesity, recent weight gain, hypothyroidism, and polycystic ovary syndrome (PCOS). Venous sinus stenosis has been implicated in the pathophysiology of IIH. Venous sinus stenting has emerged as a promising treatment option for patients who are refractory to medical therapy or intolerant to medications like acetazolamide. The VEHICLE Registry collects real-world data from multiple centers in the MENA region to evaluate the efficacy and safety of venous sinus stenting in patients with IIH. The registry analyzes patient demographics, clinical presentations, imaging findings, treatment details, and outcomes over a six-month follow-up period to improve understanding and management of IIH in this population.
Interventions
OTHERVenous Sinus Stenting Procedure
Performed under general or local anesthesia. Targeted stenosis sites included the right transverse sinus, left transverse sinus, bilateral transverse sinuses, and right transverse and sigmoid sinuses. Stents used included Venous Sinus Stent (CWS), CASPER, PRTCS, and multiple stents where necessary. Post-procedure care included antiplatelet therapy and routine follow-up assessments
Sponsors
Middle East North Africa Stroke and Interventional Neurotherapies Organization
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 to 60 years. Diagnosed with Idiopathic Intracranial Hypertension (IIH) based on the modified Dandy criteria, including: Symptoms of increased intracranial pressure (e.g., headache, visual disturbances). Elevated opening pressure (\>250 mm H₂O) on lumbar puncture with normal cerebrospinal fluid composition. No evidence of intracranial pathology (e.g., mass lesion, hydrocephalus) on neuroimaging. Presence of papilledema. Evidence of venous sinus stenosis on Magnetic Resonance Venography (MRV) or Digital Subtraction Angiography (DSA). Refractory to medical therapy or intolerant to medications (e.g., acetazolamide). Willingness to undergo venous sinus stenting. Provided informed consent for participation.
Exclusion criteria
* Secondary causes of intracranial hypertension (e.g., cerebral venous sinus thrombosis, neoplasm). Coagulopathies or contraindications to antiplatelet or anticoagulation therapy. Pregnancy or lactation. Incomplete baseline data or inability to complete follow-up assessments. Severe comorbid conditions that preclude endovascular procedures.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Symptom Improvement | Six months post-procedure. | Proportion of patients reporting significant improvement or resolution of IIH symptoms (headache, visual disturbances, tinnitus) at six months post-venous sinus stenting. |
| Change in Papilledema Grade | Six months post-procedure. | Improvement in papilledema grade assessed by fundoscopic examination using the Frisén scale from baseline to six months post-procedure. |
| Quality of Life Improvement | Baseline and six months post-procedure. | Change in Quality of Life (QOL) scores measured using a standardized questionnaire from baseline to six months post-procedure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stent Patency Rate | Six months post-procedure. | Proportion of patients with patent venous sinus stents as assessed by imaging (MRV or DSA) at six months follow-up. |
| Cranial Neuropathy Resolution | Six months post-procedure. | Resolution or improvement of cranial neuropathies (e.g., sixth nerve palsy) at six months post-procedure. |
| Adverse Events | Up to six months post-procedure. | Incidence of procedural complications or adverse events related to venous sinus stenting within six months post-procedure. |
| Visual Field Improvement | Six months post-procedure. | Improvement in visual field defects assessed by perimetry testing at six months post-procedure. |
Countries
Egypt, Saudi Arabia
Contacts
Primary Contactossama yasssin mansour, MD, PhD
Outcome results
None listed