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Shunting, optic nerve sheath fenestration and dural venous stenting for medically refractory idiopathic intracranial hypertension: systematic review and meta-analysis

  
@article{AES4345,
	author = {Daniel B. Scherman and Adam A. Dmytriw and Gia Thanh Nguyen and Nhan Thi Nguyen and Nana Tchantchaleishvili and Julian Maingard and Hamed Asadi and Mark Brooks and Christoph Griessenauer and Christopher Ogilvy and Ajith J. Thomas and Justin M. Moore and Kevin Phan},
	title = {Shunting, optic nerve sheath fenestration and dural venous stenting for medically refractory idiopathic intracranial hypertension: systematic review and meta-analysis},
	journal = {Annals of Eye Science},
	volume = {3},
	number = {6},
	year = {2018},
	keywords = {},
	abstract = {Background: Cerebrospinal fluid (CSF)-diversion procedures have traditionally been the standard of treatment for patients with medically refractive idiopathic intracranial hypertension (IIH). However, dural venous sinus stent (VSS) placement has been described as a safe and effective procedure for the management of medically refractive IIH. We performed a meta-analysis comparing outcomes and complications of CSF-diversion procedures, VSS and optic nerve sheath fenestration (ONSF) for the treatment of medically refractive IIH.
Methods: Electronic searches were performed using six databases from 1988 to January 2017. Data was extracted and meta-analysed from the identified studies.
Results: From 55 pooled studies, there were 538 CSF-diversion cases, 224 dural venous stent placements, and 872 ONSF procedures. Similar improvements were found in terms of postoperative headaches (CSF vs. VSS vs. ONSF: 84% vs. 78% vs. 62%, P=0.223), papilledema (CSF vs. VSS vs. ONSF: 71% vs. 86% vs. 77%, P=0.192), whilst visual acuity changes favored venous stenting (CSF vs. VSS vs. ONSF: 55% vs. 69% vs. 44%, P=0.037). There was a significantly lower rate of subsequent procedures with venous stent placement (CSF vs. VSS vs. ONSF: 37% vs. 13% vs. 18%, P},
	url = {http://aes.amegroups.com/article/view/4345}
}