Abstract
ObjectiveTo assess the safety and efficacy of stent thrombectomy alone or combined with intermediate catheter aspiration for severe cerebral venous sinus thrombosis.MethodWe retrospectively collected the clinical data of 7 patients with severe CVST who received endovascular treatment at our hospital from January 2017 to June 2020. The patients had at least one adverse prognostic factor (mental status disorder, comatose state, intracerebral hemorrhage, or thrombosis of the deep venous system).ResultsThe median age was 51 years. Three patients were women. Two or more venous sinuses were in involved in 5 patients. All patients received systemic anticoagulant therapy before endovascular therapy. Neurological deterioration was the main reason for patients with cerebral venous sinus thrombosis undergoing intravascular therapy. The median time from admission to intravascular therapy was 3 days (1–9 days). Primary endpoints: 6 patients (85.7%) had a modified Rankin scale score of 0 at day 90, and 1 patient (14.3%) had a modified Rankin scale score of 2 at day 90. Secondary endpoints: complete recanalization was achieved in 4 cases (57.1%) and partial recanalization in 3 cases (42.9%).ConclusionStent thrombectomy, combined with intermediate catheter aspiration, balloon dilation, and regional thrombolysis/anticoagulation treatment, is an effective strategy to treat severe cerebral venous sinus thrombosis patients who had inadequate response to anticoagulant therapy. This strategy can quickly eliminate the occluded venous sinus and improve prognosis of severe cerebral venous sinus thrombosis.
Highlights
Cerebral venous sinus thrombosis (CVST) is a rare type of stroke
The inclusion criteria for patients in our study were as follows: 1. Definite diagnosis of CVST based on head magnetic resonance imaging (MRI) of cerebral venous sinus vessels (MRV). 2
The superior sagittal sinus was involved in 7 patients (100%), the transverse sinus in 5 (71.43%), and the sigmoid sinus in 4 (57.14%)
Summary
Cerebral venous sinus thrombosis (CVST) is a rare type of stroke. The incidence of CVST in adults is 1.32 per 100,000 persons per year [1]. The incidence of CVST in women (aged 31– 50 years) is 2.78 per 100,000 per year [2]. Anticoagulant therapy is the first-line treatment for CVST [3], but nearly 20% of patients encounter disability or death [4]. Treatment of Severe CVST to poor prognosis include disordered mental status, comatose state, intracerebral hemorrhage, or thrombosis of the deep venous system [4]. There is no firm recommendation, the American Heart Association suggested that intravascular therapy be used as a remedial treatment for patients with inadequate response to anticoagulant therapy [5]
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