Venous Sinus Stenting Timing Following CSF Leak Repair: Safety and Outcomes

Background: Venous sinus stenosis has been increasingly identified as a contributing factor to idiopathic intracranial hypertension (IIH) and associated spontaneous cerebrospinal fluid (CSF) leaks. There is significant evidence demonstrating the efficacy and safety of venous sinus stenting (VSS) for this condition. However, the nuanced integration of this minimally invasive treatment option into the treatment paradigm for IIH and CSF leaks remains largely undefined. This includes the safe and optimal timing of VSS following CSF leak repair, which is an important consideration given the need for pre and post-procedure anticoagulation. Methods: We retrospectively reviewed 6 patients (5 females, 1 male) treated at our institution between 2020-2025 who underwent surgical repair of spontaneous or encephalocele-related CSF leaks followed by VSS. Clinical records and imaging were analyzed for recurrence, reoperation, meningitis, shunting, stent complications, and symptom outcomes. Patients were stratified by time from repair to stenting: short interval (