The authors report a patient with
sagittal sinus thrombosis that was resistant to reported endovascular treatments but successfully recanalized by dragging out the
thrombus using a large balloon fixed with an aspiration
catheter.
OBSERVATIONS: A 57-year-old man presented with the persistent
headache and a simple partial seizure. Diagnostic study with computed tomography and angiography demonstrated the superior sagittal sinus (SSS)
thrombosis. Due to the neurological worsening even after systemic heparinization, the patient underwent mechanical
thrombectomy. Despite six passes of
stent retrievers and a large-bore aspiration
catheter, functional recanalization was not achieved. Therefore, the so-called
dental floss technique was attempted using a large compliant balloon
catheter (Transform 7 × 7 mm). However, the balloon
catheter just wobbled along the lesion without recanalization. To restrict the movement of the balloon
catheter, the distal shaft of the balloon
catheter was fixed with the aspiration
catheter, and both the balloon and the aspiration
catheter were slowly pulled to drag the
thrombus out, resulting in recanalization of cortical veins as well as the SSS.
LESSONS: