Dural sinus stenting with the Acclino ® stent for intracranial hypertension secondary to superior sagittal sinus stenosis after meningioma resection

Background: Meningiomas located in proximity to the dural venous sinuses may cause intracranial hypertension (IH) through extrinsic compression or sinus invasion, posing significant diagnostic and therapeutic challenges. In selected patients, venous sinus stenting has emerged as a promising alternative to traditional surgical approaches. Case Description: We report the case of a 41-year-old woman presenting with chronic headache, diplopia, and papilledema secondary to superior sagittal sinus (SSS) stenosis associated with a large right parieto-occipital parasagittal meningioma. Following subtotal tumor resection, the patient exhibited increased and persistent IH with a pressure gradient of 12 mmHg across the stenotic SSS segment. Endovascular treatment was performed under general anesthesia using a low-profile, self-expanding, high-radial-force Acclino ® 8 × 40 mm stent, followed by balloon angioplasty, achieving complete resolution of the pressure gradient. The procedure was uneventful, and the patient demonstrated complete resolution of papilledema and medial rectus paresis, with substantial headache improvement and no recurrence at 1-year follow-up. Conclusion: This case shows that the Acclino ® stent provided adequate navigability, single-microcatheter deployment, and effective luminal expansion through small-caliber access sheaths. In this sense, it supports venous sinus stenting as a viable therapeutic alternative in selected patients and highlights the importance of considering venous outflow obstruction as a contributing mechanism in persistent symptoms of IH after tumor resection, warranting further studies to strengthen the evidence base for this approach.