Intravascular ultrasound characteristics of different types of stenosis in idiopathic intracranial hypertension with venous sinus stenosis

Background In this study, we analyzed the characteristics of different stenosis types in idiopathic intracranial hypertension (IIH) patients with venous sinus stenosis (VSS) using intravascular ultrasound (IVUS). Methods We retrospectively reviewed data from patients who underwent IVUS evaluation during venography or stenting procedures between January 2014 and February 2022. Results Among the 80 patients with intrinsic lesions, 47 cases were identified, including 41 single lesions and 6 multiple lesions. Single lesions consisted of 36 cases of AG, 3 cases of brain herniation, and 2 cases of septation. Multiple intrinsic lesions were found in 6 patients, with AG observed in the transverse sinus and sigmoid sinus. IVUS features varied depending on the anatomical variations of intrinsic stenosis. Additionally, among the 33 cases of extrinsic stenosis, two types were observed: unilateral compression (22 cases) and bilateral compression (11 cases), primarily affecting the transverse sinus. Conclusion IVUS effectively differentiated intrinsic and extrinsic types of stenosis and identified intraluminal and mural components of intrinsic stenosis.