Endovascular Mechanical Thrombectomy for Cerebral Venous Sinus Thrombosis: A Single-Center Experience.
Cerebral venous sinus thrombosis
Cerebral venous thrombosis
Mechanical thrombectomy
Stroke
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
16
02
2019
revised:
03
04
2019
accepted:
04
04
2019
pubmed:
14
4
2019
medline:
15
1
2020
entrez:
14
4
2019
Statut:
ppublish
Résumé
Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy in patients with severe CVT. Endovascular procedures were performed in 13 patients with CVT in addition to standard anticoagulation therapy between 2011 and 2018. Clinical and radiologic parameters, procedure details, and angiographic and clinical outcomes were reviewed retrospectively. In total, 14 thrombectomy procedures were executed. Successful recanalization of the occluded sinus was achieved in 86% of cases (12/14); of those, 29% were recanalized completely. Procedural complications included perforation of the transverse sinus in 1 case (7%). Worsening of intracranial hemorrhage occurred in 14% (2/14) of cases. Favorable clinical outcome (modified Rankin Scale score 0-2) was achieved in 12 of 13 patients (92%). Transvenous mechanical thrombectomy is feasible, safe, and effective, leading to a high degree of successful recanalization rate of occluded dural sinus. It may be a salvage treatment for selected patients with severe CVT refractory to standard medical treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Cerebral venous thrombosis (CVT) is a rare entity with a potentially fatal outcome. Patients who do not respond to standard medical therapy alone may benefit from endovascular treatment options. We evaluate the angiographic and clinical results of mechanical thrombectomy in patients with severe CVT.
METHODS
METHODS
Endovascular procedures were performed in 13 patients with CVT in addition to standard anticoagulation therapy between 2011 and 2018. Clinical and radiologic parameters, procedure details, and angiographic and clinical outcomes were reviewed retrospectively.
RESULTS
RESULTS
In total, 14 thrombectomy procedures were executed. Successful recanalization of the occluded sinus was achieved in 86% of cases (12/14); of those, 29% were recanalized completely. Procedural complications included perforation of the transverse sinus in 1 case (7%). Worsening of intracranial hemorrhage occurred in 14% (2/14) of cases. Favorable clinical outcome (modified Rankin Scale score 0-2) was achieved in 12 of 13 patients (92%).
CONCLUSIONS
CONCLUSIONS
Transvenous mechanical thrombectomy is feasible, safe, and effective, leading to a high degree of successful recanalization rate of occluded dural sinus. It may be a salvage treatment for selected patients with severe CVT refractory to standard medical treatment.
Identifiants
pubmed: 30980969
pii: S1878-8750(19)31041-1
doi: 10.1016/j.wneu.2019.04.049
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1097-e1103Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.