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Piano M, Romi A, Cervo A, Gatti A, Macera A, Pero G, Motto C, Agostoni EC, Lozupone E. Endovascular Treatment of Cerebral Vein Thrombosis: Safety and Effectiveness in the Thrombectomy Era. Diagnostics (Basel) 2023; 13:2248. [PMID: 37443641 DOI: 10.3390/diagnostics13132248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Cerebral venous thrombosis (CVT) is a rare cause of stroke that tends to affect young people. Endovascular treatment (EVT) has not yet shown to be beneficial in CVT and is therefore actually only indicated as rescue therapy in severe and refractory cases for medical treatment. Clinical, neuroimaging, procedural and follow-up data were evaluated in order to define the safety and efficacy of EVT in the management of CVT between January 2016 and December 2022. Safety was assessed on the basis of recording adverse events. Functional outcomes (NIHSS, mRS) and neuroimaging were recorded at onset, at discharge and at a 6-month follow-up. Efficacy was assessed evaluating the recanalization rate at the end of the procedure. Twenty-one patients (17 female, 4 male, range 16-84 years) with CVT underwent EVT. Overall morbidity and mortality were both at 4.7%. Median NIHSS at the onset and at the discharge were, respectively, 10 and 2. Successful recanalization was achieved in 21/23 procedures (91.3%). Imaging follow-up (FUP) showed stable recanalization in all but one patient with successful recanalization. In 18/21 patients, a good clinical independence (mRS 0-2) was recorded at 6 months. Our study adds evidence on the safety and efficacy of endovascular techniques in the treatment of CVT.
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Affiliation(s)
- Mariangela Piano
- Department of Neuroradiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Andrea Romi
- Neuroradiology Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Amedeo Cervo
- Department of Neuroradiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Antonella Gatti
- Neurology and Stroke Unit, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Antonio Macera
- Department of Neuroradiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Guglielmo Pero
- Department of Neuroradiology, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Cristina Motto
- Neurology and Stroke Unit, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Elio Clemente Agostoni
- Neurology and Stroke Unit, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Emilio Lozupone
- Department of Neuroradiology, Vito-Fazzi Hospital, 73100 Lecce, Italy
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2
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Tang SZ, Jing M, Yang C, Yeo LLL, Tan BYQ, Chan BPL, Vijay KS, Teoh HL, Anil G. Safety and clinical outcomes in endovascular treatment for symptomatic cerebral venous thrombosis: a single-center experience with meta-analysis. Neurosurg Rev 2023; 46:114. [PMID: 37160781 DOI: 10.1007/s10143-023-02012-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/05/2023] [Accepted: 04/23/2023] [Indexed: 05/11/2023]
Abstract
The role of mechanical thrombectomy (MT) in cerebral venous sinus thrombosis (CVT) is ambiguous. This study aims to share our experience with MT in CVT, supplemented by a meta-analysis on this treatment. All patients who had MT for CVT at our institution, between 2016 and 2021, were retrospectively reviewed for treatment indications, the technique used, success and complication rates, and clinical outcomes. A meta-analysis was performed for clinical and safety outcomes from published literature with > 10 patients. A total of 15 patients were included in this study. All had a venous hemorrhage or deteriorating despite anticoagulation. MT was performed using aspiration (with wide bore catheters) in 7 patients: aspiration with stent retriever in 5 and transjugular Fogarty-balloon thrombectomy in 3 patients. Adjunctive intra-sinus thrombolysis (IST) was used in 4 cases and venoplasty in 3. Technical success (restoring antegrade venous flow on arterial injection) was 100% with no procedure-related major complication. The direct transjugular approach was cheaper and faster. At 3-month follow-up, 86% of patients had good outcomes (MRS < 2). Meta-analysis of clinical and safety outcomes from 22 and 20 studies, respectively, demonstrated a positive association between MT and good outcomes as well as no significant association with hazardous periprocedural events. EVT via mechanical means for CVT is feasible in our series and meta-analysis. From our experience, trans-jugular Fogarty balloon embolectomy seems to be a potential cost-saving option, at least in a certain part of the world.
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Affiliation(s)
- Si Zhao Tang
- Division of Interventional Radiology, Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore.
| | - Mingxue Jing
- Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Cunli Yang
- Division of Interventional Radiology, Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
| | - Leonard Litt Leong Yeo
- Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Benjamin Yong-Qiang Tan
- Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Bernard Poon Lap Chan
- Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Kumar Sharma Vijay
- Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Hock-Luen Teoh
- Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Gopinathan Anil
- Division of Interventional Radiology, Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
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3
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Jedi F, Dethlefs G, Hauser TK, Hennersdorf F, Mengel A, Ernemann U, Bender B. Mechanical Thrombectomy in Cerebral Venous Sinus Thrombosis: Reports of a Retrospective Single-Center Study. J Clin Med 2022; 11:6381. [PMID: 36362608 PMCID: PMC9655339 DOI: 10.3390/jcm11216381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 10/24/2023] Open
Abstract
Current standard care for acute cerebral venous sinus thrombosis (CVST) includes either intravenous heparin or subcutaneous low-molecular-weight heparin, but patients with refractory CVST, despite adequate anticoagulation therapy, may benefit from mechanical thrombectomy (MT). A retrospective study of patients with CVST, who underwent MT between 2011 and 2019, was performed looking at procedure success rate and clinical outcomes. Two raters evaluated the cerebral venous system of every patient before and after the intervention using the following scoring system: (0) No obvious thrombosis; (1) thrombosis without impaired blood flow; (2) thrombosis with impaired blood flow; (3) and thrombosis with complete vascular occlusion. The success of MT was measured using a score quotient (Q = A/B), dividing the sum of the patient's scores after the intervention (A) by the sum of scores before the intervention (B). Overall, 21 MTs were performed on 20 patients with refractory or severe CVST. Clinical improvement was seen in 61.9% during hospital stay and in 80% at 6-month follow-up, with complete recovery in 70% of patients. Patients with favorable outcomes had significantly lower recanalization quotients (p = 0.008). Our study provides evidence supporting that MT may be a safe and effective treatment with favorable clinical outcomes for selected patients with CVST.
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Affiliation(s)
- Farzaneh Jedi
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Gero Dethlefs
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Till-Karsten Hauser
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Florian Hennersdorf
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Annerose Mengel
- Department of Neurology and Stroke, Hertie-Institute for Clinical Brain Research, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, 72076 Tübingen, Germany
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4
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Nepal G, Kharel S, Bhagat R, Coghlan MA, Yadav JK, Goeschl S, Lamichhane R, Phuyal S, Ojha R, Shrestha GS. Safety and efficacy of endovascular thrombectomy in patients with severe cerebral venous thrombosis: A meta-analysis. J Cent Nerv Syst Dis 2022; 14:11795735221131736. [PMID: 36204279 PMCID: PMC9530583 DOI: 10.1177/11795735221131736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022] Open
Abstract
Background Cerebral venous thrombosis (CVT) is a rare thrombotic condition which is traditionally
treated with anti-coagulation therapy. Subsets of patients with severe CVT have been
treated with endovascular thrombectomy (EVT). Despite the high estimated mortality
associated with severe CVT, there has been only one randomized control trial done
regarding safety and efficacy of EVT in severe CVT compared to standard medical
management. Evidence in this area is lacking. Objective The aim of this systematic review is to analyze all existing literature and generate
robust information regarding the role of EVT in the management of patients with severe
CVT. Methods This systematic review and meta-analysis followed PRISMA guideline. PubMed, Embase,
Google Scholar, and CNKI were searched for eligible studies from 2007 to 2021. Safety
and efficacy of EVT were evaluated by meta-analyzing recanalization status, the good
functional outcome at follow-up, recurrent CVT, new hematoma. A pooled proportion with a
95% confidence interval was derived from a meta-analysis of various outcomes (CI). Results A total of 33 studies comprising 610 patients treated with EVT were included for
analysis which comprised one randomized control trial, one prospective study and 31
retrospective studies. Based on pooled data, 85% of patients had good functional
outcome, 62% had complete recanalization, 5% had all-cause mortality, and 3% had
catheter related complications. The efficacy outcomes in this analysis had a significant
heterogeneity and a subgroup analysis was also done to explain these findings. The
minimum time of follow up was 3 months and varied EVT techniques were used across the
studies. Conclusion This meta-analysis suggests EVT may be safe and efficacious in treating patients with
severe CVT. Registration Our protocol was registered with PROSPERO: International prospective register of
systematic reviews with the registration number CRD42021254760.
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Affiliation(s)
- Gaurav Nepal
- Department of Internal Medicine,
Maharajgunj Medical Campus, Tribhuvan University Institute of
Medicine, Maharajgunj, Nepal
| | - Sanjeev Kharel
- Department of Internal Medicine,
Maharajgunj Medical Campus, Tribhuvan University Institute of
Medicine, Maharajgunj, Nepal
| | - Riwaj Bhagat
- Department of Neurology, Boston University Medical Center, Boston, MA, USA
| | - Megan A Coghlan
- Department of Neurology, University of Louisville School of
Medicine, Louisville, KY, USA
| | - Jayant K Yadav
- Department of Internal Medicine,
Maharajgunj Medical Campus, Tribhuvan University Institute of
Medicine, Maharajgunj, Nepal
| | - Stella Goeschl
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Rajan Lamichhane
- Department of Internal Medicine,
Maharajgunj Medical Campus, Tribhuvan University Institute of
Medicine, Maharajgunj, Nepal
| | - Subash Phuyal
- Department of Neuroimaging and
Interventional Neuroradiology, Upendra Devkota Memorial National Institute of
Neurological and Allied Sciences, Bansbari, Nepal
| | - Rajeev Ojha
- Department of Neurology, Tribhuvan University Teaching
Hospital, Maharajgunj, Nepal
| | - Gentle S Shrestha
- Department of Critical Care Medicine, Tribhuvan University Teaching
Hospital, Maharajgunj, Nepal,Gentle S Shrestha, Department of Critical Care
Medicine, Tribhuvan University Teaching Hospital, Maharajgunj 44600, Kathmandu, Nepal.
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5
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Endovascular Treatment of Intracranial Vein and Venous Sinus Thrombosis—A Systematic Review. J Clin Med 2022; 11:jcm11144215. [PMID: 35887982 PMCID: PMC9319519 DOI: 10.3390/jcm11144215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Cerebral venous sinus or vein thromboses (SVT) are treated with heparin followed by oral anticoagulation. Even after receiving the best medical treatment, numerous patients experience neurological deterioration, intracerebral hemorrhage or brain edema. Debate regarding whether endovascular treatment (EVT) is beneficial in such severe cases remains ongoing. This systematic review summarizes the current evidence supporting the use of EVT for SVT on the basis of case presentations, with a focus on patient selection, treatment strategies and the effects of the COVID-19 pandemic. Methods: This systemic literature review included randomized controlled trials (RCTs) and retrospective observational data analyzing five or more patients. Follow-up information (modified Rankin scale (mRS)) was required to be provided (individual patient data). Results: 21 records (n = 405 patients; 1 RCT, 20 observational studies) were identified. EVT was found to be feasible and safe in a highly selected patient cohort but was not associated with an increase in good functional outcomes (mRS 0–2) in RCT data. In observational data, good functional outcomes were frequently observed despite an anticipated poor prognosis. Conclusion: The current evidence does not support the routine incorporation of EVT in SVT treatment. However, in a patient cohort prone to poor prognosis, EVT might be a reasonable therapeutic option. Further studies determining the patients at risk, choice of methods and devices, and timing of treatment initiation are warranted.
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6
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Lee Q, Yu X, Yu W. Treatment of a non-purulent intracranial venous sinus thrombus using a thrombectomy aspiration system: A case report. J Interv Med 2021; 4:97-100. [PMID: 34805956 PMCID: PMC8562299 DOI: 10.1016/j.jimed.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 12/03/2022] Open
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7
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Andersen TH, Hansen K, Truelsen T, Cronqvist M, Stavngaard T, Cortsen ME, Holtmannspötter M, Højgaard JLS, Stensballe J, Welling KL, Gutte H. Endovascular treatment for cerebral venous sinus thrombosis - a single center study. Br J Neurosurg 2020; 35:259-265. [PMID: 32648493 DOI: 10.1080/02688697.2020.1786498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disorder. The majority of these patients respond favorably to systemic anticoagulation. However, a subset of patients will deteriorate clinically, despite optimal medical therapy. METHODS Retrospective single center study of 28 consecutive CVST patients treated with systemic anticoagulation and additional endovascular therapy. RESULTS Median age was 37.5 years (range 15-76 years), there were 21 (75%) women, and 20 (71%) had thrombosis involving ≥2 venous sinuses. Intracranial hemorrhage (ICH) was present at admission in 18 patients (64%). Endovascular therapy consisted of local thrombolysis in 26 (93%) patients; 9 patients (32%) had additional mechanical thrombectomy, and in 2 (7%) patients thrombectomy alone was performed. Complete recanalization at end of the final intervention was achieved in 15 patients (54%), partial recanalization in 11 patients (39%), whereas there was no recanalization in 2 patients (7%). On follow-up imaging, conducted between 3 and 6 months, recanalization further improved to 76%, 19% and 5%, respectively. A favorable outcome (mRS ≤ 2) was achieved in 63% of patients at 3 months, which improved to 79% at 6 months. Post-procedural ICH or volume expansion of preexisting ICH was seen in 9 patients (32%). In total 5 patients died (18%). CONCLUSIONS Systemic anticoagulation with the addition of endovascular therapy with local thrombolysis and/or mechanical thrombectomy is a potential strategy to obtain recanalization in patients with CVST who deteriorate clinically despite medical therapy or are comatose. Endovascular therapy may increase the risk of ICH.
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Affiliation(s)
- Thomas Hasseriis Andersen
- Department of Radiology, Neurovascular Section, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Klaus Hansen
- Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Thomas Truelsen
- Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Mats Cronqvist
- Department of Radiology, Neurovascular Section, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Trine Stavngaard
- Department of Radiology, Neurovascular Section, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Marie Elisabeth Cortsen
- Department of Radiology, Neurovascular Section, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Markus Holtmannspötter
- Department of Radiology, Neurovascular Section, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Jakob Stensballe
- Section for Transfusion Medicine, Capital Region Blood Bank, Rigshospitalet, Denmark.,Department of Anesthesiology, Centre of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Karen Lise Welling
- Department of Neuroanesthesiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Henrik Gutte
- Department of Radiology, Neurovascular Section, Copenhagen University Hospital, Rigshospitalet, Denmark
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8
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Ilyas A, Chen CJ, Ding D, Romeo A, Buell TJ, Wang TR, Kalani MYS, Park MS. Magnetic resonance-guided, high-intensity focused ultrasound sonolysis: potential applications for stroke. Neurosurg Focus 2019; 44:E12. [PMID: 29385918 DOI: 10.3171/2017.11.focus17608] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Stroke is one of the leading causes of death worldwide and a significant source of long-term morbidity. Unfortunately, a substantial number of stroke patients either are ineligible or do not significantly benefit from contemporary medical and interventional therapies. To address this void, investigators recently made technological advances to render transcranial MR-guided, high-intensity focused ultrasound (MRg-HIFU) sonolysis a potential therapeutic option for both acute ischemic stroke (AIS)-as an alternative for patients with emergent large-vessel occlusion (ELVO) who are ineligible for endovascular mechanical thrombectomy (EMT) or as salvage therapy for patients in whom EMT fails-and intracerebral hemorrhage (ICH)-as a neoadjuvant means of clot lysis prior to surgical evacuation. Herein, the authors review the technological principles behind MRg-HIFU sonolysis, its results in in vitro and in vivo stroke models, and its potential clinical applications. As a noninvasive transcranial technique that affords rapid clot lysis, MRg-HIFU thrombolysis may develop into a therapeutic option for patients with AIS or ICH. However, additional studies of transcranial MRg-HIFU are necessary to ascertain the merit of this treatment approach for thrombolysis in both AIS and ICH, as well as its technical limitations and risks.
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Affiliation(s)
- Adeel Ilyas
- Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Ching-Jen Chen
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Dale Ding
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
| | - Andrew Romeo
- Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Thomas J Buell
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Tony R Wang
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - M Yashar S Kalani
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
| | - Min S Park
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia; and
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9
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Cioni S, Casseri T, Vallone IM, Gennari P, Romano DG, Leonini S, Acampa M, Tassi R, Martini G, Bracco S. Letter regarding "Combined aspiration thrombectomy and continuous intrasinus thrombolysis for cerebral venous sinus thrombosis: technical note and case series". Neuroradiology 2019; 61:845-846. [PMID: 31143983 DOI: 10.1007/s00234-019-02232-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 05/20/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Samuele Cioni
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera e Universitaria Senese, Viale Bracci 13, 53100, Siena, SI, Italy
| | - Tommaso Casseri
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera e Universitaria Senese, Viale Bracci 13, 53100, Siena, SI, Italy.
| | - Ignazio M Vallone
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera e Universitaria Senese, Viale Bracci 13, 53100, Siena, SI, Italy
| | - Paola Gennari
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera e Universitaria Senese, Viale Bracci 13, 53100, Siena, SI, Italy
| | - Daniele G Romano
- Neuroradiology Unit, Ospedale San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Sara Leonini
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera e Universitaria Senese, Viale Bracci 13, 53100, Siena, SI, Italy
| | - Maurizio Acampa
- Stroke Unit, Azienda Ospedaliera e Universitaria Senese, Siena, Italy
| | - Rossana Tassi
- Stroke Unit, Azienda Ospedaliera e Universitaria Senese, Siena, Italy
| | - Giuseppe Martini
- Stroke Unit, Azienda Ospedaliera e Universitaria Senese, Siena, Italy
| | - Sandra Bracco
- Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera e Universitaria Senese, Viale Bracci 13, 53100, Siena, SI, Italy
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10
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Fujii S, Yoshimura M, Hirota S, Kiyokawa J, Yamamoto S. Thrombus in the Superior Sagittal Sinus Was Successfully Aspirated by Coaxial Catheter Technique: A Technical Case Report. JOURNAL OF NEUROENDOVASCULAR THERAPY 2019; 13:44-48. [DOI: 10.5797/jnet.tn.2018-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Affiliation(s)
- Shoko Fujii
- Department of Neurosurgery, Oume Municipal General Hospital, Tokyo, Japan
| | - Masataka Yoshimura
- Department of Neurosurgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Shin Hirota
- Department of Neurosurgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
| | - Juri Kiyokawa
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Shinji Yamamoto
- Department of Neurosurgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Ibaraki, Japan
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11
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Najjar AA, Rasheedi JK, Kurdi KI, Hasan AA, Almekhlafi MA, Baeesa SS. Endovascular suction thrombectomy for severe cerebral venous sinus thrombosis: A report of two cases. J Taibah Univ Med Sci 2017; 13:87-92. [PMID: 31435308 PMCID: PMC6694903 DOI: 10.1016/j.jtumed.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 06/16/2017] [Accepted: 06/29/2017] [Indexed: 02/05/2023] Open
Abstract
Cerebral venous sinus thrombosis (CVST) is a severe clinical condition that manifests with diverse symptoms that can be mild, taking the form of a headache, or can be life-threatening, with raised intracranial pressure and herniation. Despite systemic anticoagulation treatment, CVST still carries a mortality risk of approximately 10% because of the failure of venous recanalization by anticoagulants alone. This paper describes two cases with extensive CVST who presented with progressive neurological deterioration despite adequate systemic anticoagulation treatment. Both patients were successfully treated with endovascular clot removal using suction thrombectomy techniques with immediate recanalization of the sinuses and rapid radiographic improvement. The described therapy appears effective and safe; however, further studies are needed to validate the effectiveness of this treatment.
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Affiliation(s)
- Ahmed A. Najjar
- Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Jameel K. Rasheedi
- Division of Neurology, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
| | - Khalil I. Kurdi
- Department of Radiology, King Faisal Specialist Hospital and Research Centre, Jeddah, KSA
| | - Ahmed A. Hasan
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Jeddah, KSA
| | | | - Saleh S. Baeesa
- Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA
- Corresponding address: Department of Neurosurgery, Faculty of Medicine, King Abdulaziz University, P.O. Box 80215, Jeddah 21589, KSA.
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12
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Ilyas A, Chen CJ, Raper DM, Ding D, Buell T, Mastorakos P, Liu KC. Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a systematic review. J Neurointerv Surg 2017; 9:1086-1092. [DOI: 10.1136/neurintsurg-2016-012938] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 02/02/2017] [Accepted: 02/03/2017] [Indexed: 12/26/2022]
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