Impact of body mass index on clinical outcomes after venous sinus stenting for idiopathic intracranial hypertension

BACKGROUND: Venous sinus stenting is used to treat medically refractory cases of idiopathic intracranial hypertension (IIH). While obesity predisposes to developing IIH, there is limited knowledge of how body mass index (BMI) affects outcomes after VSS. OBJECTIVE: To assess how baseline BMI and change in BMI affects clinical outcomes after VSS. METHODS: This was a retrospective study of patients who underwent VSS for IIH at a single center in the United States from January 2022 and December 2024. Delta BMI was defined as (BMI at 6 months) - (BMI at baseline). The primary outcome was reintervention after six months of the initial VSS procedure, defined as when patients required re-operation through repeat VSS or CSF shunt placement. RESULTS: (31.9-42.6). Of the cohort, 14.3% (n = 16) experienced 30-day ED visits, 6.2% (n = 7) were readmitted within 30-days and 25.9% (n = 29) required reintervention. After excluding 10 patients who underwent reintervention within six months, 102 patients were included in the landmark analysis, and 18.6% (n = 19) underwent reintervention after six months. On multivariable analysis, baseline BMI (OR: 1.09, 95% CI: 1.02-1.1.19, P = 0.02) was associated with higher odds for reintervention. Delta BMI was not significantly associated with reintervention (OR: 1.02, 95% CI: 0.81-1.28), P = 0.86). CONCLUSION: Baseline BMI was associated with higher odds for reintervention after VSS, while change in BMI at six months was not associated with reintervention. Future prospective studies could aim to validate these findings.