Introduction: Venous sinus stenosis is a part and a potential cause of a clinical syndrome called idiopath- ic intracranial hypotension (IIH). The venous stenosis may obstruct venous blood outflow, therefore result in increased intravenous pressure, reduced regional blood flow, intractable headaches, pulsatile tinnitus and pro- gressive visual loss.

Venous sinus stenting is a treatment of venous sinus stenosis. It is a minimally invasive procedure, starting with pressure measurement and followed by intravenous stenting if needed. This involves placement of a metal- lic mesh in the shape of a tube in the narrowed vein to expand the vein and resolve the narrowing. This results in lower pressure values of the sinuses and the cerebro- spinal fluid, therefore improves clinical symptoms like headache and visual disturbances.

Aim: To present the practice of venous sinus stenting and the related assistant duties, by showing one case per- formed in our Institute.

Methods and materials: We need simultaneous arte- rial and venous approach during the whole procedure. A 4F/5F catheter is introduced from the radial artery into the internal carotid artery and a 6F/8F guiding catheter is introduced from the common femoral vein into the inter- nal jugular vein. From this position, a microcatheter is in- serted into the superior saggital sinus using a microwire. Microcatheter pressure measurement can be performed using the arterial pressure gauge of the anesthesia ma- chine or a dedicated device connected to the angio ta- ble. Before and after the stenosis, we measure at several points for 30 seconds long.

Results: The result of the pressure measurement deter- mines whether it is necessary to stent the venous sinus or to apply conservative therapy. A pressure difference of at least 8-10 mm Hgmm is considered abnormal, in which case angioplasty is indicated. After stenting, control pres- sure measurements are performed.

Conclusion: The Venous Sinus pressure measurement is suitable for assessing venous sinus stenosis and help us to decide for or against stenting.

Keywords: venous sinus stenosis, IIH, venous sinus stenting, neurointervention

Funding: none.