1446. Venous Sinus Stenting for Idiopathic Intracranial Hypertension in the United States, 2009 – 2014: An analysis of epidemiology, cost and complications

Authors: Osama Ahmed; Anthony Ma, MS; Jun Hui Lee, BA; Isaac Freedman, MPH; Andrew Koo, BS; Branden Cord, MD, PhD; Jacky Yeung, MD (New Haven, CT)

Introduction: Venous sinus stenting (VSS) is an uncommon endoscopic procedure for treating idiopathic intracranial hypertension (IIH). There are no nation-wide studies looking at the epidemiology, costs and complications associated with this procedure. 

Methods: We queried the National Inpatient Sample (NIS), which accounts for 20% of all inpatient admissions in the U.S, for all cases with a primary diagnosis of IIH (ICD-9 CM: 348.2) from 2009-2014. Data on patient characteristics, payer information, treatment cost and post-operative complications was analyzed. 

Results: Our analysis identified 52 patients. Average age of patients was 30.2 years (range: 16-54) and 96% of patients were women. Number of surgeries reported in the NIS grew from 4 in 2009 to 20 in 2014. 24 surgeries were performed in the South, 14 in the West, 10 in the North Central and 4 in the North East regions of the country. The most common payers were private insurances (n = 29) followed by Medicaid (n = 10). The average length of stay in the hospital was 2.4 days (range: 0-29 days). All cases followed routine discharge and there were no post-operative deaths. Patients only had a maximum of 1 complication per surgery, and the average rate of complications was 5.8%. Complications included post-operative hematoma (n=2) and cardiac complications (n=1). The mean cost of hospitalization for VSS was $66,296 (standard deviation: $46,304). On univariate analysis, increasing length of stay (p = 0.01), more recent year of surgery (p = 0.03) and African American race (p = 0.006) were associated with higher cost.

Conclusions: Though costs of the procedure are rising with time, the procedure has a low rate of complication and a short length of stay for most patients.