Mechanical thrombectomy as first-line treatment for venous sinus thrombosis: technical considerations and preliminary results using the AngioJet device.

Abstract

BACKGROUND:

Cerebral venous sinus thrombosis (CVT) is an uncommon cause of stroke that is usually treated medically with intravenous heparin therapy followed by long-term anticoagulation therapy. A series of patients with CVT who underwent rheolytic thrombectomy with the AngioJet as a first-line adjunctive treatment in addition to standard anticoagulation therapy is presented.

METHODS:

Prospectively maintained endovascular databases at two institutions were retrospectively reviewed. The available clinical and imaging data were compiled at each institution and combined for analysis.

RESULTS:

Over 18 months, 13 patients (seven women and six men; age range 17-73 years, median age 45 years) with CVT were treated with rheolytic thrombectomy. Immediate (partial or complete) recanalization of the thrombosed intracranial sinuses was achieved in all patients. At a median radiographic follow-up of 7 months there was continued patency of all recanalized sinuses. Clinical follow-up was available on nine patients: modified Rankin score of 0 in four patients, 1 in three patients and 6 in two patients.

CONCLUSION:

This series demonstrates the feasibility of performing mechanical thrombectomy as a first-line treatment for acute CVT. This technique facilitates the prompt restoration of intracranial venous outflow, which may result in rapid neurological and symptomatic improvement.

• Authors: Shervin R Dashti, Yin C Hu, Tom Yao, David Fiorella, Alim P Mitha, Felipe C Albuquerque, Cameron G McDougall
• Journal: Journal of neurointerventional surgery (J Neurointerv Surg) Vol. 5 Issue 1 Pg. 49-53 (Jan 01 2013) ISSN: 1759-8486 [Electronic] England
• PMID: 22146573 (Publication Type: Case Reports, Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Aged
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Radiography
• Retrospective Studies
• Sinus Thrombosis, Intracranial (diagnostic imaging, surgery)
• Thrombectomy (instrumentation, methods)
• Treatment Outcome
• Young Adult