Initial experience with the antithrombogenic-coated CARESTO stent for venous sinus stenting for idiopathic intracranial hypertension: A multicenter study

ObjectivesTo evaluate the feasibility, safety, and short-term efficacy of the antithrombogenic-coated CARESTO stent for venous sinus stenting (VSS) in idiopathic intracranial hypertension (IIH).MethodsThis retrospective multicenter study included IIH patients with venous sinus stenosis fulfilling the modified Dandy criteria, elevated lumbar puncture opening pressure, and a trans-stenotic pressure gradient ≥ 7 mmHg. Clinical endpoints were improvement of headache, papilledema, and visual function. Imaging endpoints included stent patency, venous sinus diameter, and restenosis. Physiological endpoints were the reduction of the trans-stenotic pressure gradient and lumbar puncture opening pressure. Safety was assessed by recording peri- and postprocedural complications.ResultsBetween January 2023 and August 2025, 16 IIH patients underwent VSS with the CARESTO stent at four centers. Mean age was 33.9 ± 6.9 years; 75% were female. Stent deployment was technically successful in all cases. The median trans-stenotic gradient fell from 18 to 3 mmHg and lumbar puncture pressure from 34 to 16.5 cmH₂O at 3 months, with sinus diameter increasing from 2.0 to 7.0 mm. All patients improved clinically, 81.3% within 24 hours. At 3 months, all stents were patent without restenosis, complications, or mortality.ConclusionVSS with the antithrombogenic-coated CARESTO stent appears feasible, safe, and effective, providing consistent short-term clinical, hemodynamic, and physiological benefits in IIH. Further prospective studies in larger cohorts are warranted and may open the door to performing VSS under single antiplatelet therapy.