Angiography and clinical analysis of intracranial venous sinus in jugular foramen

Background By analyzing the digital subtraction angiography (DSA) of intracranial venous sinus in jugular foramen segment, this article investigates the reasons for difficulty or failure of stent implanting in intracranial venous sinus, and attempts to formulate the clinical index, which can predict the difficulty of venous sinus stenting so as to improve the success rate of stent implantation. Methods All of 118 patients treated with venous sinus stent angioplasty were analyzed retrospectively, among whom 87 cases were diagnosed as cerebral venous stenosis and intracranial hypertension, and 31 patients were diagnosed as intractable pulsatile tinnitus caused by venous sinus stenosis. All patients received thrombolysis, anticoagulant and antiplatelet agents, and stent was implanted since the symptoms were not relieved. The two turning angles and diameter of cerebral venous sinus in the jugular foramen were measured to analyze their impact on stent implantation. Results Stent implantation of 115 cases were successful, while 3 patients did not complete the surgery due to the difficulty of stent implanting. The cerebral venous sinus in the jugular foramen was a transitional structure between the sigmoid sinus and internal jugular vein. Lateral view of angiography suggested "N" shape. The sum of two turning angles of venous sinus of 115 patients was (120.11± 30.32)°, and the diameter of venous sinus was (5.10 ± 1.12)mm. The sum of two turning angles of 3 patients who failed to implant stent was (86.37 ± 10.72)°, and the diameter of venous sinus was (5.11 ± 0.37) mm. There were statistically significant differences between the angles of two groups (t = 23.420, P = 0.001), but no significant differences between the diameters of two groups ( t = 7.210, P = 0.352). Conclusion Lateral view of angiography suggested "N" shape of venous sinus in the jugular foramen. Difficulty of stent embedding would be caused by too small turning angles of venous sinus in the jugular foramen. However, the diameter of venous sinus did not influence the sugery ofstent implantation.