Endovascular treatment of tumor-related dural sinus stenosis, venous outflow obstruction, and secondary intracranial hypertension: a systematic review of the literature.

Authors

Victor Gabriel El-Hajj, Maria Gharios, Joanna M Roy, Basel Musmar, Preston Carey, William Mualem, Hani Chanbour, James Feghali, Anant Naik, Victor E Staartjes, Adrian Elmi-Terander, Elias Atallah, Rabab Alshahrani, Nikolaos Mouchtouris, Robert H Rosenwasser, Stavropoula Tjoumakaris, M Reid Gooch, Pascal Jabbour

Published in

Journal of neuro-oncology. Volume 178. Issue 3. Jun 27, 2026. Epub Jun 27, 2026.

Abstract

Tumors involving dural venous sinuses can lead to venous outflow obstruction and secondary intracranial hypertension. While surgical resection can decompress the sinus, such procedures carry significant risks. With the success of endovascular interventions for idiopathic intracranial hypertension (IIH), venous sinus stenting (VSS) and angioplasty have emerged as potential treatments for tumor-related sinus stenosis. However, evidence remains limited and dispersed. This systematic review aimed to synthesize the available literature on the safety and efficacy of endovascular treatment for tumor-related venous sinus obstruction.
A systematic search of PubMed, Embase, and Web of Science was conducted from database inception to November 2025. Eligible studies included any report describing endovascular treatment (VSS and/or angioplasty) for tumor-related venous sinus obstruction, whether due to tumor invasion or compression, or even stenosis following surgery or radiotherapy. Data on patient demographics, tumor characteristics, procedural details, and outcomes were extracted and summarized descriptively.
Twenty studies comprising 57 patients were included. Most patients were female (65%) with a mean age of 48 years. Meningioma represented the most common underlying tumor (75%). The majority of obstructions resulted from tumor compression or invasion (86%), and most patients underwent VSS alone (74%), while the rest underwent VSS and angioplasty (23%). No periprocedural complications were reported. Mean trans-stenotic pressure gradient decreased by 10 ± 9 mmHg post-treatment and mean lumbar opening pressure decreased by 11 ± 12 cmH2O. Clinical improvement was reported in 63% of patients, including resolution or improvement of papilledema in 94% and vision changes in 94%. Repeat intervention was required in 28% of cases, and only about half of patients achieved further improvement after reintervention.
Endovascular therapy for tumor-related venous sinus stenosis appears safe and effective, leading to meaningful pressure reduction and symptomatic improvement in two-thirds of patients. These findings support VSS as a viable adjunct or alternative to surgery in selected patients. Nonetheless, the certainty of evidence remains very low, and current data cannot establish definitive conclusions.

PMID:
42364002
Bibliographic data and abstract were imported from PubMed on 27 Jun 2026.

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