The pattern of surgical treatments for Idiopathic Intracranial Hypertension (IIH) in the United States is not well-studied, specifically the trend of utilizing endovascular venous stenting (EVS) as an emerging technique. In this cross-sectional study, we aimed to explore the national trend of utilizing different procedures for the treatment of IIH including EVS, Optic Nerve Sheath Fenestration (ONSF), and CSF Shunting, with a focus on novel endovascular procedures. Moreover, we explored rates of 90-day readmission and length of hospital stay following different procedures, besides the effects of sociodemographic and clinical parameters on procedure choice. 36,437 IIH patients were identified from records between 2010-2018. Those in the EVS group were 29 years old on average, and 93.4% were female. Large academic hospital setting was independently associated with higher EVS utilization, while other factors were not predictive of procedure choice. The proportion of EVS use in IIH hospitalizations increased significantly from 2010 to 2018 (P <0.001), while there was a relative decline in the frequency of shunting procedures (P =0.001), with ONSF utilization remaining stable (P=0.39). The rate of 90-day readmission and length of hospital stay were considerably lower following EVS compared to other procedures (Ps<0.001). This study presents novel population-level data on national trends in the frequency and outcome of EVS for IIH therapy. EVS was associated with shorter length of hospital stays and fewer readmission rates. In addition, a continuous increase in venous stenting compared to other procedures suggests an increasing role for endovascular therapies in IIH.

中文翻译：

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特发性颅内高压血管内和手术治疗的全国趋势

在美国，特发性颅内高压 (IIH) 的手术治疗模式尚未得到充分研究，特别是利用血管内静脉支架 (EVS) 作为新兴技术的趋势。在这项横断面研究中，我们旨在探索利用不同手术治疗 IIH 的全国趋势，包括 EVS、视神经鞘开窗术 (ONSF) 和脑脊液分流术，重点是新型血管内手术。此外，除了社会人口统计学和临床​​参数对手术选择的影响之外，我们还探讨了不同手术后 90 天的再入院率和住院时间。从 2010 年至 2018 年间的记录中发现了 36,437 名 IIH 患者。EVS组的平均年龄为29岁，其中93.4%为女性。大型学术医院环境与较高的 EVS 使用率独立相关，而其他因素并不能预测手术选择。2010年至2018年，IIH住院中EVS使用比例显着增加（P <0.001），而分流手术频率相对下降（P = 0.001），ONSF使用保持稳定（P = 0.39）。与其他手术相比，EVS 后 90 天的再入院率和住院时间显着降低（Ps<0.001）。本研究提供了关于 IIH 治疗 EVS 频率和结果的国家趋势的新人口水平数据。EVS 与较短的住院时间和较低的再入院率相关。此外，与其他手术相比，静脉支架置入术的持续增加表明血管内治疗在 IIH 中的作用越来越大。