Combined aspiration thrombectomy and continuous intrasinus thrombolysis for cerebral venous sinus thrombosis: technical note and case series

Combined aspiration thrombectomy and continuous intrasinus thrombolysis for cerebral venous sinus thrombosis: technical note and case series

Cerebral venous sinus thrombosis is an uncommon cause of stroke with high morbidity and mortality rates from venous infarction, intracranial hemorrhage, and extensive cerebral edema. Endovascular treatment with various devices has been proposed as a salvage treatment when standard medical treatment...

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Bibliographic Details
Published in:Neuroradiology Vol. 60; no. 10; pp. 1093 - 1096
Main Authors: Tsang, Anderson Chun On, Hwang, A. C., Chiu, R. H. Y., Chan, D. Y. C., Tsang, F. C. P., Ho, W. S., Lee, R., Leung, G. K. K., Lui, W. M.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2018
Springer Nature B.V
Subjects:
Adult
Aged
Anticoagulants
Boring tools
Cardiovascular system
Catheters
Cerebral infarction
Combined Modality Therapy
Edema
Female
Hemorrhage
Humans
Imaging
Infarction
Magnetic Resonance Imaging
Male
Medical treatment
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Patients
Radiology
Retrospective Studies
Salvage
Salvage Therapy
Short Report
Sinus Thrombosis, Intracranial - diagnostic imaging
Sinus Thrombosis, Intracranial - therapy
Sinuses
Thrombectomy - methods
Thromboembolism
Thrombolysis
Thrombolytic Therapy - methods
Thrombosis
Treatment Outcome
Thrombolysis
Thrombectomy
Venous sinus thrombosis
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Summary:Cerebral venous sinus thrombosis is an uncommon cause of stroke with high morbidity and mortality rates from venous infarction, intracranial hemorrhage, and extensive cerebral edema. Endovascular treatment with various devices has been proposed as a salvage treatment when standard medical treatment with systemic anticoagulation is ineffective, especially in long segment dural sinus thrombosis. We describe our technique of transvenous endovascular aspiration thrombectomy with large bore thrombectomy catheters, followed by placement of microcatheter for local thrombolytic infusion at the site of thrombosis. We report a retrospective study of angiographic and clinical outcome of six consecutive patients treated with this approach. Endovascular aspiration thrombectomy with large bore catheters followed by continuous local thrombolytic infusion appeared to be a safe and effective salvage treatment for selected patients with cerebral dural venous sinus thrombosis refractory to medical treatment.
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ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-018-2084-3